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In-Office Awake Vocal Fold Steroid Injection

Contributors: Clark A. Rosen

Superficial injection of steroids into the true vocal folds can be performed to reduce or prevent vocal fold scar formation as well as for treatments of benign vocal fold lesions.

DOI: http://dx.doi.org/10.17797/zle2prpaif

Editor Recruited By: Michael M. Johns, III, MD

In-office awake vocal fold steroid injection
Mild to moderate vocal fold scar Benign vocal fold lesions Post-benign vocal fold lesion removal to facilitate healing by reducing inflammation
Need for global vocal fold augmentation Patient anxiety Significant gag reflex Medical comorbidities that contraindicate an in-office procedure
Patient sits in an upright position in a chair. Physician driving the laryngoscope stands on the patient¢s right side while the assistant, who passes the lidocaine drip catheter and injector, stands on the patient¢s left.
Blood pressure and heart rate measurements before the procedure.
Good knowledge of the laryngeal anatomy.
Advantages: Avoids general anesthesia, easy patient tolerability Disadvantages: Usually done serially thus requires multiple procedures
Vasovagal reaction, epistaxis, vocal fold hematoma, vocal fold atrophy after serial dexamethasone injection
Vasovagal reaction, epistaxis, vocal fold hematoma, vocal fold atrophy after serial dexamethasone injection
N/A
Campagnolo AM, Tsuji DH, Sennes LU, Imamura R, Saldiva PH. Histologic study of acute vocal fold wound healing after corticosteroid injection in a rabbit model. Ann Otol Rhinol Laryngol. 2010;119(2):133-9. Zhou H, Sivasankar M, Kraus DH, Sandulache VC, Amin M, Branski RC. Glucocorticoids regulate extracellular matrix metabolism in human vocal fold fibroblasts. Laryngoscope. 2011;121(9):1915-9. Wang CT, Lai MS, Hsiao TY. Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions. J Voice. 2015;29(5):578-87. Shi LL, Giraldez-Rodriguez LA, Johns MM 3rd. The Risk of Vocal Fold Atrophy after Serial Corticosteroid Injections of the Vocal Fold. J Voice. 2015 Nov 24. [Epub ahead of print] Office steroid injections of the larynx. Mortensen M, Woo P. Laryngoscope. 2006 Oct;116(10):1735-9.

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