Abstract：
OBJECTIVE: Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG.
METHODS: We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.
RESULTS: Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction <75%), whereas prior intubation was associated with better response.
CONCLUSIONS: For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.
METHODS: We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.
RESULTS: Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction <75%), whereas prior intubation was associated with better response.
CONCLUSIONS: For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.
摘要：
目的：声带肉芽肿（VPG）是一种慢性疾病，由声带粘壁神经损伤引起。最初的保守治疗通常包括声乐卫生教育和抗反流药物。难治性病例出现治疗挑战。二线治疗如手术切除和肉毒杆菌毒素注射的结果仍然不一致。因此，我们建议这项研究来调查病灶内注射类固醇治疗难治性VPG的有效性。
方法：我们对23例使用质子泵抑制剂3个月后无改善的VPG患者进行了回顾性分析。这些患者每月接受一到三个疗程的办公室内病灶内类固醇注射作为二线治疗。通过在最终注射程序之前和之后测量VPG相对于声带长度的大小来评估治疗结果。
结果：结果显示VPG大小从基线的27.74±15.06显著降低至5.48±8.95（p<.001）。23例患者中有15例对病灶内类固醇注射有反应（大小减小≥75％）。饮酒和较长的症状持续时间与不良反应相关（大小减少<75％），而之前的插管与更好的反应相关。
结论：对于保守治疗无效的难治性VPG，病灶内注射类固醇似乎是一种有希望的替代选择,没有明显的不良反应.
方法：我们对23例使用质子泵抑制剂3个月后无改善的VPG患者进行了回顾性分析。这些患者每月接受一到三个疗程的办公室内病灶内类固醇注射作为二线治疗。通过在最终注射程序之前和之后测量VPG相对于声带长度的大小来评估治疗结果。
结果：结果显示VPG大小从基线的27.74±15.06显著降低至5.48±8.95（p<.001）。23例患者中有15例对病灶内类固醇注射有反应（大小减小≥75％）。饮酒和较长的症状持续时间与不良反应相关（大小减少<75％），而之前的插管与更好的反应相关。
结论：对于保守治疗无效的难治性VPG，病灶内注射类固醇似乎是一种有希望的替代选择,没有明显的不良反应.
