Office steroid injections of the larynx.
OBJECTIVE
Steroid injection into the larynx has been sporadically reported as helpful in benign lesions of the larynx. Its role in laryngology remains unclear. This study reviews the indications and results of 47 steroid injections in 34 patients in an office setting.


METHODS
The authors conducted a retrospective review of 47 injections in 34 patients. Methylprednisolone acetate suspension, USP (40 mg/mL), was injected by indirect laryngoscopy under local anesthesia. Results were evaluated by stroboscopy and by perceptual evaluation of the GRABS scale before and after injection. Pre- versus postinjection ratings were compared by paired t test.


RESULTS
Indications for injection were: 1) postoperative scar with local stiffness (12 patients), 2) vocal nodules and polyp (18 patients), and 3) sarcoidosis/granuloma (4 patients). Steroid injections were done in professional singers instead of repeated oral administration of steroids and/or to avoid surgery in patients with polyps and cysts. Improvement was noted in 28 of 34 (82%). Eleven of the 18 patients with polyps and nodules had significant improvement and avoided surgery. Vocal fold scars improved after injection with an improved voice grade (P < .01), an improved amplitude (P < .05), and improved mucosal wave (P < .05). There were no complications. Only two patients could not tolerate office injection.


CONCLUSIONS
Office steroid injections are a valuable adjunct in management of vocal fold scars, polyps, nodules, and granulomas.
Mortensen
Melissa
M
Department of Otolaryngology Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, USA.
Woo
Peak
P
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002921:Cicatrix / Q000188:drug therapy; D003560:Cysts / Q000188:drug therapy; D006102:Granuloma, Laryngeal / Q000188:drug therapy; D006801:Humans; D015552:Injections, Intralesional; D007818:Laryngeal Diseases / Q000188:drug therapy*; D007828:Laryngoscopy; D008775:Methylprednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077555:Methylprednisolone Acetate; D010824:Physicians' Offices; D011127:Polyps / Q000188:drug therapy; D011183:Postoperative Complications / Q000188:drug therapy; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000188:drug therapy; D049489:Stroboscopy; D014833:Voice Quality / Q000502:physiology
D000893:Anti-Inflammatory Agents; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone