Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma

Area of Science:

• Otolaryngology
• Laryngology
• Medical Therapeutics

Background:

• Vocal process granuloma (VPG) is a chronic condition often requiring advanced treatment.
• Standard conservative therapies like vocal hygiene and proton pump inhibitors may be insufficient for refractory VPG.
• Existing second-line treatments, including surgery and botulinum toxin, have inconsistent outcomes.

Purpose of the Study:

• To evaluate the efficacy of intralesional steroid injections as a second-line treatment for refractory vocal process granuloma.
• To assess the impact of intralesional steroid injections on VPG size reduction.

Main Methods:

• Retrospective review of 23 patients with VPG refractory to 3 months of proton pump inhibitors.
• Patients received one to three monthly courses of in-office intralesional steroid injections.
• VPG size was measured relative to vocal fold length before and after treatment.

Main Results:

• Significant reduction in VPG size from 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001).
• 15 of 23 patients (65%) achieved ≥ 75% size reduction.
• Poor response associated with alcohol use and longer symptom duration; prior intubation linked to better response.

Conclusions:

• Intralesional steroid injection is a viable and promising treatment for refractory VPG.
• This therapeutic option demonstrates significant efficacy without notable adverse effects.
• Further investigation into factors influencing treatment response may optimize patient selection.