Korean J Otorhinolaryngol-Head Neck Surg.  2020 Nov;63(11):511-516. 10.3342/kjorl-hns.2019.00507.

The Effect of Vocal Fold Steroid Injection via Cricothyroid Membrane in Patients with Vocal Polyp

• Nam W
• Noh SH
• Lee J
• Kim SW
• Jin SM
• Lee SH

• KMID: 2509262
• DOI: http://doi.org/10.3342/kjorl-hns.2019.00507

Abstract

Background and Objectives
Vocal polyps are generally caused by phonotrauma such as vocal overuse, and the first line treatment is known as laryngeal microsurgery. The aim of the study is to evaluate the applicability and effectiveness of percutaneous steroid injection via cricothyroid membrane in patients with vocal polyp and to evaluate its advantages and limitations of the technique.
Subjects and Method
We included in this study 70 patients with vocal polyp managed by vocal fold steroid injection via the cricothyroid membrane from Jan 2008 to July 2018. We compared their medical records of laryngoscopy, stroboscopy, and multi-dimensional voice program analysis at pre and post treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30).
Results
Of the patients, 54.3 percent showed morphological improvement. In acoustic analysis, the pre-treatment mean values of jitter, shimmer, and NHR were 2.20±2.23, 5.09±3.24, 0.15±0.04, respectively. The post-treatment values were 1.54±1.28, 5.00±4.40, 0.13±0.04, respectively, and only jitter was statistically significant. For subjective symptom improvement, 32 (45.8%) patients showed better score on the post-treatment of VHI-30 compared to pretreatment. Ten patients experienced mild complications such as vocal fold atrophy and scar; however, no critical complications such as internal bleeding or dyspnea were reported.
Conclusion
According to our study, steroid injection is a safe and effective procedure for patients with vocal polyp. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery.

Keyword

Steroid injection; Treatment; Vocal fold; Vocal polyp; Voice