J Korean Soc Laryngol Phoniatr Logoped.  2022 Dec;33(3):166-171. 10.22469/jkslp.2022.33.3.166.

Analysis of the Effect of Intralesional Steroid Injection on the Voice During Laryngeal Microsurgery

• Park JS
• Kang HS
• Lee IB
• Jin SM
• Lee SH

• KMID: 2539108
• DOI: http://doi.org/10.22469/jkslp.2022.33.3.166

Abstract

Background and Objectives
Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality. Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke’s edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed.
Results
There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke’s edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results.
Conclusion
There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.

Keyword

Vocal folds; Microsurgery; Steroids; Injections; Wound healing; 성대; 미세수술; 스테로이드; 주사; 창상치유