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Corticosteroid Injections a Safe Alternative to Surgery for Vocal Fold Polyps CHICAGO -- August 17, 2009 -- Corticosteroid injections appear to offer an alternative to surgery for treating polyps on the vocal cords, according to a study published in the August issue of Archives of Otolaryngology-Head & Neck Surgery. “Although some small vocal fold polyps may resolve with conservative treatment, typically, these polyps do not change in size in response to voice therapy,” the authors wrote. “Surgical removal with direct microlaryngoscopic technique under general anaesthesia is considered standard treatment and is recommended in most cases.” However, surgery requires specialised instruments, carries the risks involved with general anaesthesia, and may result in vocal fold scarring or stiffness if it is performed multiple times. Yen-Bin Hsu, MD, National Yang-Ming University and Taipei Veterans General Hospital, Taipei, Taiwan, and colleagues reported on the applicability of an alternative to surgery, injection of corticosteroids through the skin and into the vocal folds. In the study, 24 patients with vocal fold polyps received this treatment between March 1 and December 31, 2007. They were followed up at 1 and 3 months afterward, and every 3 months thereafter. The procedure was completed smoothly in 22 of the 24 patients (92%), with no complications and typically within 20 minutes, the authors noted. The unsuccessful procedures were due to thick, soft neck tissue or to the patient having an overly sensitive gag reflex. When examined by stroboscopy the overall response rate was 91% (20 of 22). “The polyps disappeared in 5 patients (23%) at 1 month after the percutaneous corticosteroid injection and in 13 (59%) after a 3-month follow-up period,” the authors wrote. “No further improvement was noted at 6 months.” Two patients experienced recurrence of their vocal fold polyps at 6 and 9 months after the injection. “In contrast to traditional microlaryngoscopic surgery, percutaneous corticosteroid injection avoids possible scar formation and a second injection can be considered if necessary,” they continued. “In addition, this technique avoids the need for direct microlaryngoscopic instruments and the expense and risk of general anaesthesia.” SOURCE: Archives of Otolaryngology-Head & Neck Surgery E-mail this page to a friend or colleague! To print, use this version