台耳醫誌

BACKGROUND: This study was aimed toward analyzing the outcomes of benign laryngeal lesion (BLL) management through the use of steroid vocal injections (SVIs) and to explore the predictive factors correlated with BLL treatment improvement.
METHODS: From May 2018 to February 2020, 27 consecutive BLL patients with 41 lesions at National Cheng Kung University Hospital, Tainan, Taiwan were enrolled. All patients received SVIs. Pre- and post-operative assessments related to an endoscopic evaluation of size reduction in the vocal lesion area using ImageJ imaging processing and analysis software, acoustic analysis, and 10-item Voice Handicap Index (VHI-10) were retrospectively collected. A multivariable linear regression with the generalized estimating equations (GEE) method was applied to evaluate the effectiveness of SVIs and to identify potential factors predictive of outcome.
RESULTS: Among the 27 patients, 15 patients were male, and the mean age of the included subjects was 46.3 years old. Compared to pre-operation, more than 85% of the patients showed improvement in reduction of the lesion area, and SVIs were found to significantly decrease the BLL sizes to 30.8%, 56%, and 47% at within 2 weeks, between 2-6 weeks, and after 6 weeks follow-up, respectively (all p-values ＜ 0.05). The GEE analysis showed that being female and younger age were associated with a better response in the reduction of lesions after SVIs. However, the results of the acoustic analysis and the VHI-10 were improved without statistical difference.
CONCLUSIONS: SVIs significantly reduces the BLL area. The percentage reduction was better in female and younger patients. In addition, objective and subjective voice outcomes demonstrated improvement trends. SVIs may thus be a reliable tool to manage BLLs.
(J Taiwan Otolaryngol Head Neck Surg 2021; 56:23-32)