Document Detail

Local steroid injection via the cricothyroid membrane in patients with a vocal nodule.
MedLine Citation:
PMID:  22006779     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To analyze the usefulness and safety of a steroid injection into vocal nodules via the cricothyroid membrane. Local administration of steroid directly into the larynx has been reported in many laryngeal diseases with different methods.
DESIGN: Prospective case series at an academic tertiary care hospital.
PATIENTS: Eighty patients with vocal nodules were enrolled between December 2008 and May 2010.
INTERVENTIONS: Triamcinolone acetonide was injected through the cricothyroid membrane with a transnasal flexible laryngoscope to patients in a sitting position.
MAIN OUTCOME MEASURES: Vocal nodules were evaluated before and 2 and 4 weeks after the injection; improvement was assessed both objectively and subjectively.
RESULTS: The nodules disappeared in 35 patients by the fourth week after the injection (44%), and 39 patients showed improvement (49%). Jitter, shimmer, maximum phonation time, and mean voice handicap index also improved significantly after the steroid injection (P < .05 for all). Six patients with voice-related occupations showed improvement at the second week (8%), but the nodules had recurred after 4 weeks. Four patients experienced mild vocal fold atrophy, and 2 patients showed a white plaque formation on the vocal fold that resolved spontaneously 1 to 2 months after the injection.
CONCLUSIONS: A local steroid injection via the cricothyroid membrane is a useful and safe treatment option for vocal nodules. However, vocal nodules are caused mainly by excessive voice use; therefore, nodules can recur unless the voice use pattern changes. Further study of this treatment technique, including long-term follow-up, is needed.
Sang-Hyuk Lee; Jang-Ok Yeo; Jeong-Im Choi; Hee-Jin Jin; Jin-Pyeong Kim; Seung-Hoon Woo; Sung-Min Jin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  137     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  2011-12-29     Revised Date:  2012-08-15    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1011-6     Citation Subset:  AIM; IM    
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyeong-dong, Jongno-gu, Seoul, South Korea.
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MeSH Terms
Glucocorticoids / administration & dosage*
Injections / methods*
Laryngeal Diseases / drug therapy*,  pathology
Laryngeal Muscles*
Middle Aged
Prospective Studies
Treatment Outcome
Triamcinolone Acetonide / administration & dosage*
Vocal Cords*
Young Adult
Reg. No./Substance:
0/Glucocorticoids; 76-25-5/Triamcinolone Acetonide
Comment In:
Arch Otolaryngol Head Neck Surg. 2012 Jun;138(6):608   [PMID:  22710522 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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