Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma.

Clin Otolaryngol

Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Published: November 2024

AI Article Synopsis

  • Vocal process granuloma (VPG) is a persistent throat condition that doesn't always improve with standard treatments like vocal hygiene and medication, leading to a need for alternative therapies.
  • A study involving 23 patients who were unresponsive to initial treatments showed that intralesional steroid injections significantly reduced the size of VPG lesions after multiple sessions.
  • The findings suggest that steroid injections could be a safe and effective second-line option for patients with refractory VPG, especially for those with certain characteristics that influence treatment response.

Article Abstract

Objectives: Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG.

Methods: We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.

Results: Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction <75%), whereas prior intubation was associated with better response.

Conclusions: For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.

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Source
http://dx.doi.org/10.1111/coa.14210DOI Listing

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