title: The Risk of Vocal Fold Atrophy after Serial Corticosteroid Injections of the Vocal Fold.
abstract: OBJECTIVE
  The aim of this study was to illustrate the risk of vocal fold atrophy in patients who receive serial subepithelial steroid injections for vocal fold scar.
  
  
  METHODS
  This study is a retrospective case report of two patients who underwent a series of weekly subepithelial infusions of 10 mg/mL dexamethasone for benign vocal fold lesion. Shortly after the procedures, both patients developed a weak and breathy voice. The first patient was a 53-year-old man with radiation-induced vocal fold stiffness. Six injections were performed unilaterally, and 1 week later, he developed unilateral vocal fold atrophy with new glottal insufficiency. The second patient was a 67-year-old woman with severe vocal fold inflammation related to laryngitis and calcinosis, Raynaud's phenomenon, esophagean dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome. Five injections were performed bilaterally, and 1 week later, she developed bilateral vocal fold atrophy with a large midline glottal gap during phonation. In both cases, the steroid-induced vocal atrophy resolved spontaneously after 4 months.
  Serial subepithelial steroid infusions of the vocal folds, although safe in the majority of patients, carry the risk of causing temporary vocal fold atrophy when given at short intervals.
authors.affiliation: Emory Voice Center, Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Lucy L
authors.initials: LL
authors.lastname: Shi
authors.affiliation: Emory Voice Center, Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia; The Voice and Swallowing Center of Puerto Rico, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
authors.forename: Laureano A
authors.initials: LA
authors.lastname: Giraldez-Rodriguez
authors.affiliation: Emory Voice Center, Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia. Electronic address: michael.johns2@emory.edu.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Johns
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D001284:Atrophy; D002921:Cicatrix / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007267:Injections; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000187:drug effects*; D012189:Retrospective Studies; D012307:Risk Factors; D049489:Stroboscopy; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording; D014827:Vocal Cords / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D014832:Voice Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014833:Voice Quality / Q000187:drug effects*
chemical_list: D000305:Adrenal Cortex Hormones; D003907:Dexamethasone
keywords: Benign vocal fold disorders; Injection; Steroid; Vocal fold atrophy; Vocal scar