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Yen-Bin Hsu, MD; Ming-Chin Lan, MD; Shyue-Yih Chang, MD

Arch Otolaryngol Head Neck Surg. 2009;135(8):776-780.

Objectives  To evaluate the applicability and effectiveness of percutaneous corticosteroid injection in patients with vocal fold polyp and to describe its advantages and limitations in this group of patients.

Design  Prospective case series.

Setting  Tertiary care teaching hospital.

Patients  Twenty-four patients with vocal fold polyp treated between March 1 and December 31, 2007.

Interventions  Percutaneous corticosteroid injection performed with the patient under topical anesthesia. Stroboscopic examination was carried out to evaluate the postoperative response.

Main Outcome Measures  The Grade of the Severity of Dysphonia, Roughness, Breathiness, Asthenicity, and Strain (GRBAS) scale and the Voice Handicap Index were used for subjective assessments. Phonatory results including maximum phonation time, mean flow rate, jitter, shimmer, and noise to harmonic ratio were also collected for objective evaluations.

Results  The surgery was completed smoothly in 22 of the 24 patients, typically within 20 minutes. No complications were noted. The overall response rate by stroboscopy was 91% (20 of 22 patients) and complete remission rate was 59% (13 of 22). A significant improvement was noted between preoperative and postoperative results on the GRBAS scale (P < .001, P < .001, P = .003, P = .001, and P = .002, respectively, for the 5 measures). Mean Voice Handicap Index (P = .001), maximum phonation time (P = .02), jitter (P = .006), shimmer (P = .001), and noise to harmonic ratio (P = .01) also improved significantly after percutaneous corticosteroid injection.

Conclusions  Percutaneous corticosteroid injection can be used to manage vocal fold polyps with low invasiveness and minimal morbidity. It offers a simple and cost-effective alternative to traditional direct microlaryngoscopic procedures.

Author Affiliations: Institute of Clinical Medicine, National Yang-Ming University, Taipei (Drs Hsu and Lan); and Departments of Otolaryngology, Taipei Veterans General Hospital, Taipei (Drs Hsu and Chang), National Yang-Ming University, Taipei (Drs Hsu and Chang), Taipei Tzu Chi General Hospital, Taipei (Dr Lan), and Tzu Chi University, Hualien (Dr Lan), Taiwan.

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