SUMMARY
Objectives
Vocal fold nodules (VFNs) are bilateral, mid-membranous, swellings of the vocal folds.
Intralesional steroid injection was successfully tried in the management of benign
vocal fold lesions including nodules. The aim of the present study was to compare
treatment outcomes of vocal fold steroid injection (VFSI) and surgery in patients
with VFNs in terms of lesion regression, subjective, and objective voice parameters.
Study design
Nonrandomized controlled clinical trial.
Methods
This bicenter interventional study was conducted on 32 patients with VFNs, in the
age range of 16–63 years. Sixteen patients underwent transnasal VFSI under local anesthesia
(the injection group), and 16 underwent surgical excision of the nodules under general
anesthesia (the surgery group). Prior to intervention and at the follow-up visit,
participants were subjected to videolaryngoscopic examination with evaluation of nodules’
sizes as well as subjective voice assessment by auditory perceptual assessment (APA)
of voice and the international nine-item Voice Handicap Index (VHI-9i). Objective
voice assessments including the measurements of cepstral peak prominence, jitter,
shimmer, harmonic to noise ratio, and maximum phonation time were also administered.
Results
The size of vocal fold nodules was significantly decreased postintervention in both
studied groups. There was a decrease in the VHI-9i score, a decrease in the values
of jitter and shimmer, together with an increase in the values of cepstral peak prominence
and maximum phonation time after interventions indicating improvement of subjective
and objective voice outcomes in both groups.
Conclusion
Office-based transnasal VFSI is a safe and tolerable therapy option for VFNs. Voice
outcomes of VFSI were comparable to surgery, hereby VFSI can be considered a promising
therapy for VFNs and could be used as an alternative to surgery in selected cases.
KEY WORDS
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Article info
Publication history
Published online: March 06, 2023
Accepted:
February 3,
2023
Publication stage
In Press Corrected ProofFootnotes
No funding was received for conducting this study.
Identification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
