First-line treatment of exudative vocal fold-lesions by in-office local corticosteroid injection: A literature review - 15/05/21
, E. De Monès del PujolBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objectives |
There are emerging reports of the effectiveness of in-office awake vocal-fold corticosteroid injection in the treatment of exudative vocal-fold lesions. The aim of this study was to review this therapy and specify indications, practical modalities and outcomes.
Study design |
Systematic review of the literature without meta-analysis.
Methods |
A systematic review by PubMed search for the period January 2000 to December 2018 was carried out.
Results |
Nine articles were included, for a total of 502 lesions: nodules (46.4%), polyps (31.7%), and Reinke's edema (21.9%). Submucosal injection of low-dose triamcinolone acetonide (0.1 to 0.3mL) was transoral, transcutaneous or transnasal via flexible endoscope with operating channel. Lesion volume was significantly reduced in more than 90% of cases, with significant vocal improvement in all studies. Relapse rates ranged between 4% and 31%, with time to relapse of 1 to 40 months.
Conclusions |
First-line treatment of exudative glottic lesions by submucosal corticosteroid injection provides at least transient significant reduction in lesion volume and vocal improvement. It is consensually reserved to moderate-sized mainly exudative lesions without fibrosis. In-office injection provides an immediate therapeutic response in case of vocal impairment, enabling surgery under general anesthesia to be postponed.
Le texte complet de cet article est disponible en PDF.Keywords : Exudative vocal-fold lesions, Reinke's edema, Vocal nodule, Vocal polyp, In-office procedure, Corticosteroid injection
Plan
Vol 138 - N° 3
P. 169-175 - mai 2021 Retour au numéro
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