title: Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar.
abstract: Persistent dysphonia from vocal fold scar remains a clinical challenge, with current therapies providing inconsistent outcomes. We evaluated voice outcomes after a single office-based steroid injection.
  
  
  
  Case series with chart review.
  
  
  
  Academic medical center.
  
  
  
  This study was based on pre- and postoperative analysis of patient-reported, perceptual, acoustic, aerodynamic, and videostroboscopic parameters. The sample comprised 25 patients undergoing office-based dexamethasone injection into the superficial lamina propria for mild/moderate vocal fold scar. Average follow-up was 13.7 ± 4.4 weeks; patients completed 3.5 ± 2.3 sessions of voice therapy between assessments. Complete data sets were not available for each parameter; sample size is noted with results.
  
  
  
  Voice handicap index (n = 24; P < .001) and glottal function index (n = 22; P < .001) decreased after injection. Total GRBAS score (grade, roughness, breathiness, asthenia, strain) decreased (n = 25; P < .001). Fundamental frequency range increased (n = 24; P = .024). Phonation threshold pressure decreased (n = 14; P = .017). Videostroboscopic parameters of vocal fold edge (P = .004), glottic closure (P = .003), and right mucosal wave (P = .016) improved after injection.
  
  
  
  Office-based steroid injection combined with voice therapy for mild/moderate vocal fold scar is associated with improved patient-reported and functional voice measures. These findings provide preliminary support for this approach. Importantly, the procedure is low risk and can be performed in the office, thus offering a simple treatment alternative to patients with a disorder that has traditionally been difficult to manage. Prospective studies evaluating the effects of multiple injections are warranted.
authors: Proliance Eastside Ear Nose and Throat, Kirkland, Washington, USA.|Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: William G
authors: WG
authors: Young
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Matthew R
authors: MR
authors: Hoffman
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Ian J
authors: IJ
authors: Koszewski
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.|Austin Ear, Nose & Throat Clinic, Austin, Texas, USA.
authors: Chad W
authors: CW
authors: Whited
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Brienne N
authors: BN
authors: Ruel
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA dailey@surgery.wisc.edu.
authors: Seth H
authors: SH
authors: Dailey
mesh_terms: D002921:Cicatrix / Q000188:drug therapy* / Q000209:etiology*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D055154:Dysphonia / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010699:Phonation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014833:Voice Quality; D014922:Wisconsin
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: dysphonia; steroid injection; vocal fold injection; vocal fold scar