Transnasal endoscopic steroid injection for treatment of vocal fold polyps (a noninvasive technique)

Abstract

Background Numerous studies have demonstrated the effectiveness of vocal fold steroid injection for treating benign laryngeal lesions, including vocal nodules, polyp, cyst, and Reinke’s edema. Glucocorticoids are the most-effective anti-inflammatory agents available, as they offer symptom alleviation in a series of clinical manifestations. Objective This study was designed to investigate the clinical applicability, effectiveness, and adverse events of transnasal endoscopic steroid injection for benign vocal fold polyps. Patients and methods This study was conducted on 25 patients with vocal cord polyps, under monitoring using a high-resolution camera system. Injection was performed using a disposable 180 cm long flexible varices needle inserted into the operating channel of the fiberoptic nasolaryngoscope. Results Endoscopic evaluation revealed complete resolution of the polyps in five (20%) patients after 1 month and in 12 (48%) patients after 3 months. Polyp size was reduced in 18 (72%) patients after 1 month and in 11 (44%) patients after 3 months, whereas two cases had no change in polyp size after the procedure. The maximum phonation time before the procedure of an average of 10.2 s was prolonged to an average of 13.5 s after the procedure. The mean flow rate before the procedure was 225 ml/s, which was reduced to 172 ml/s after the procedure. Conclusion The transnasal endoscopic steroid injection has the advantages of allowing surgical manipulations under direct visual guidance, thus ensuring an accurate easy approach to the lesion. The procedure can be used for patients refusing or unfit for general anesthesia.

Keywords

• fiberoptic laryngeal surgery
• steroid injection
• vocal polyp