Office-Based Treatment of Vocal Fold Scarring with Transcutaneous Chordal Steroid Injections

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  • Sanuki Tetsuji
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University
  • Kumai Yoshihiko
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University
  • Toya Yutaka
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University
  • Nishimoto Kohei
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University
  • Kodama Narihiro
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University
  • Yumoto Eiji
    Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University

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  • 外来で行う瘢痕声帯に対するステロイド局所注射

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Scarring of the vocal folds can result from blunt laryngeal trauma or more commonly due to surgical iatrogenic injury after the removal of vocal fold lesions. The scarring results from the replacement of healthy tissue with stiff fibrous tissue that can irrevocably alter vocal function, leading to a decreased or absence of the vocal fold mucosal wave. Current treatments for this complex condition are inconsistent and often produce suboptimal results. This study reviews the outcomes of 13 patients who, in an office setting, underwent transcutaneous chordal steroid injections with curved needles for vocal fold scarring. <BR>This injection technique was performed under local anesthesia. Results were evaluated by videostroboscopy, perceptual evaluation of the GRBAS scale, and acoustic analysis before and after the injections. <BR>Injections were given from 2 to 5 times. These steroid injections did not completely clear scar lesions in all patients, although videostroboscopic observations revealed improvement in 11 patients. In perceptual evaluations, all cases experienced a progressive improvement of voice quality with the passage of time after the injections. With the acoustic findings, all parameters showed significant improvement after the injections. <BR>Our experience showed a positive response of scars to steroid injection therapy. Repeated transcutaneous chordal steroid injections using curved needles offer significant improvement in the management of vocal fold scars.

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