Intracordal injection therapy for vocal fold scarring: Steroid versus basic fibroblast growth factor

Laryngoscope Investigative Otolaryngology

article

Miki Nozawa MD¹  Satoka Takahashi MD¹  Takeharu Kanazawa MD, PhD¹  Kazuya Kurakami MD, PhD²  Tomohiro Hasegawa MD²  Mayu Hirosaki MD²  Manami Kamitomai MD²  Daigo Komazawa MD²  Ujimoto Konomi MD, PhD²  Makoto Ito MD, PhD¹  Yusuke Watanabe MD² 

[1] Division of Laryngeal Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Jichi Medical University;Tokyo Voice Center, International University of Health and Welfare;Department of Otolaryngology-Head and Neck Surgery, Yamagata University, Faculty of Medicine;AKASAKA Voice Health Center;Voice and Dizziness Clinic Futakotamagawa Otolaryngology

关键词: bFGF;    intracordal injection therapy;    office surgery;    steroids;    vocal fold scarring;   

DOI  :  10.1002/lio2.881

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives Vocal fold scarring is caused by replacement of vocal fold mucosa with fibrous tissue due to repeated inflammation or trauma. It can lead to severe dysphonia. It is currently treated conservatively and with phonosurgery and intracordal injections. Intracordal injection of steroid or basic fibroblast growth factor (bFGF) has been recently found to be useful for treating vocal fold scarring that does not respond to voice therapy. Methods This retrospective study involved the administration of steroid injection and bFGF injection bilaterally under local anesthesia in 16 patients each. Laboratory measurements of voice parameters were performed before and 3–6 months after injection. Results In the steroid injection group, the Voice Handicap Index (VHI) score significantly improved from 57.1 to 40.5, total Grade, Roughness, Breathiness, Asthenia, Strain (tGRBAS) score significantly improved from 4.2 to 2.6, and mean speech fundamental frequency (SFF) increased from 192.5 to 211.4 dB, but there was no improvement in maximum phonation time (MPT) and mean airflow rate (MFR). In the bFGF injection group, significant improvements in the VHI score (from 53.3 to 35.7), MPT (from 16.9 to 21.8 s) and MFR (from 314.6 to 210.5 ml/s) were seen; however, the tGRBAS score did not improve. In addition, the SFF significantly decreased from 178.1 to 160.5 Hz. Conclusion These results suggest that both steroid and bFGF injections are effective for treating vocal fold scarring, with steroids improving voice quality and bFGF improving glottic closure, thereby contributing to improvements in VHI scores. Level of Evidence 4.

【 授权许可】

CC BY|CC BY-NC-ND