성대 용종 환자에서 경윤상 갑상막 접근을 통한 성대 내 스테로이드 주입술의 효과
The Effect of Vocal Fold Steroid Injection via Cricothyroid Membrane in Patients with Vocal Polyp
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Background and Objectives Vocal polyps are generally caused by phonotrauma such asvocal overuse, and the first line treatment is known as laryngeal microsurgery. The aim of thestudy is to evaluate the applicability and effectiveness of percutaneous steroid injection viacricothyroid membrane in patients with vocal polyp and to evaluate its advantages and limitationsof the technique. Subjects and Method We included in this study 70 patients with vocal polyp managed byvocal fold steroid injection via the cricothyroid membrane from Jan 2008 to July 2018. Wecompared their medical records of laryngoscopy, stroboscopy, and multi-dimensional voiceprogram analysis at pre and post treatment. Subjective voice improvement was evaluated usingVoice 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 forpatients with vocal polyp. A vocal fold steroid injection via the cricothyroid membrane can bean alternative treatment option for those who are not able to undergo conventional laryngealmicroscopic surgery.
Abstract
Background and Objectives Vocal polyps are generally caused by phonotrauma such asvocal overuse, and the first line treatment is known as laryngeal microsurgery. The aim of thestudy is to evaluate the applicability and effectiveness of percutaneous steroid injection viacricothyroid membrane in patients with vocal polyp and to evaluate its advantages and limitationsof the technique. Subjects and Method We included in this study 70 patients with vocal polyp managed byvocal fold steroid injection via the cricothyroid membrane from Jan 2008 to July 2018. Wecompared their medical records of laryngoscopy, stroboscopy, and multi-dimensional voiceprogram analysis at pre and post treatment. Subjective voice improvement was evaluated usingVoice 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 forpatients with vocal polyp. A vocal fold steroid injection via the cricothyroid membrane can bean alternative treatment option for those who are not able to undergo conventional laryngealmicroscopic surgery.
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