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Clinical Efficacy of Vocal Fold Steroid Injection for Benign Vocal Fold Lesions: A Systematic Review and
Mariam Ibrahium Abdelshafy1, Tamer Shoukry Sobhy1, Mona Sameeh Khodeir1
1Ain Shams University Faculty of Medicine, Cairo, Egypt.
Background:
Benign vocal fold lesions (BVFLs), including nodules, polyps, cysts, and Reinke's edema, are a major cause of persistent dysphonia and can significantly impair quality of life and occupational voice performance. Traditional management includes voice therapy and phonosurgery; however, vocal fold steroid injection (VFSI) has emerged as a minimally invasive, office-based alternative.
Objective:
This study aims to systematically evaluate the clinical efficacy of VFSI in BVFLs, assessing both patient-reported and objective outcomes, and to explore variability in response across lesion types.
Methods:
A systematic review and meta-analysis of studies published between January 2012 and early 2026 was conducted in accordance with PRISMA guidelines. Fourteen studies involving 694 patients were included. Outcomes included Voice Handicap Index-10 (VHI-10) scores and endoscopic measures of lesion improvement. Random effects models were applied, and heterogeneity and publication bias were assessed.
Results:
The pooled lesion improvement rate was 78.4% (95% CI: 70.3-85.1%). VHI-10 scores showed a significant mean reduction of 14.6 points, corresponding to an approximate 44% improvement in perceived voice handicap. Triamcinolone acetonide was the most commonly used corticosteroid, although dexamethasone and betamethasone were also utilized. The mean patient age was 42.0 years, with a predominance of female patients (77.1%). Subgroup analyses suggested greater responsiveness in inflammatory lesions compared to fibrotic or scar-related lesions. Substantial heterogeneity was observed (I² >90%), likely reflecting differences in baseline severity, lesion type, and injection techniques. The mean follow-up duration was 5.1 months.
Conclusion:
VFSI is an effective, minimally invasive treatment for BVFLs, demonstrating significant improvements in both voice outcomes and lesion size. However, heterogeneity across studies underscores the need for standardized protocols and lesion-specific prospective trials. Future research should focus on optimizing steroid selection, injection techniques, and long-term outcomes.
