title: Efficacy and Safety of Adjunctive Steroid Injection After Microsurgical Removal of Benign Vocal Fold Lesions.
abstract: OBJECTIVE
  This study aims to investigate the clinical efficacy and safety of immediate intralesional steroid injection in patients undergoing laryngeal microsurgery (LMS) for benign vocal fold lesions (BVFLs).
  
  
  METHODS
  This is a single-institution, retrospective cohort study.
  
  
  METHODS
  Patients were divided into two groups according to whether or not they received adjunctive steroid injection after LMS. We evaluated the outcomes using objective, perceptual voice analysis and videostroboscopy. We also analyzed clinical parameters and identified risk factors associated with persistent dysphonia after LMS.
  
  
  RESULTS
  The study included a total of 211 patients with BVFLs (82 men and 129 women), which comprised 136 vocal polyps (64.5%), 49 nodules (23.2%), and 30 cysts (14.2%); 84 patients (39.8 %) had intralesional steroid administration combined with LMS. The overall results for postoperative voice parameters in both groups were significantly improved. On videostroboscopic examination, the rate of recurrent lesions was lower in the group that received adjunctive steroid injection than in the group with only LMS (P = 0.014). In the multivariate analysis, older age (compared to <50 years of age; odds ratio [OR] = 2.697, 95% confidence interval [CI]: 1.300-5.595, P = 0.008) and duration of hoarseness longer than 6 months (compared to <3 months; OR = 2.729, 95% CI: 1.193-6.242, P = 0.017) were identified as independent risk factors associated with persistent dysphonia. Nevertheless, adjunctive steroid injection was associated with a 0.3-fold (OR = 0.345, 95% CI: 0.152-0.784, P = 0.011) lower risk of persistent dysphonia.
  
  
  CONCLUSIONS
  Steroid injection combined with LMS in the treatment of BVFLs was safe and associated with improved voice quality.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Jung-Hae
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Sang-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Park
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Woo-Seob
authors.initials: WS
authors.lastname: Hwang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: hnsdi@catholic.ac.kr.
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Sun
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007818:Laryngeal Diseases / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D007828:Laryngoscopy; D016015:Logistic Models; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D020127:Recovery of Function; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D066106:Seoul; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D049489:Stroboscopy; D013997:Time Factors; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014741:Video Recording; D014827:Vocal Cords / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids; D014222:Triamcinolone Acetonide
keywords: Benign vocal fold lesion; Dysphonia; Injection; Laryngeal microsurgery; Steroid