Objectives The aim of the present study was to compare treatment outcomes of vocal fold steroid
injection (VFSI) and surgery in patients with vocal fold (VFNs) in terms of lesion
regression, subjective, and objective voice parameters.
Methods This bicenter interventional study was conducted on 32 patients with VFNs, in the
age range of 16−63 years. Sixteen patients underwent transnasal VFSI under local anesthesia
(the injection group), and 16 underwent surgical excision of the nodules under general
anesthesia (the surgery group). Prior to intervention and at the follow-up visit,
participants were subjected to videolaryngoscopic examination with evaluation of nodules"
sizes as well as subjective voice assessment by auditory perceptual assessment (APA)
of voice and the international nine-item Voice Handicap Index (VHI-9i). Objective
voice assessments including the measurements of cepstral peak prominence, jitter,
shimmer, harmonic to noise ratio, and maximum phonation time were also administered.
Results The size of vocal fold nodules was significantly decreased postintervention in both
studied groups. There was a decrease in the VHI-9i score, a decrease in the values
of jitter and shimmer, together with an increase in the values of cepstral peak prominence
and maximum phonation time after interventions indicating improvement of subjective
and objective voice outcomes in both groups.
Conclusion Office-based transnasal VFSI is a safe and tolerable therapy option for VFNs. Voice
outcomes of VFSI were comparable to surgery, hereby VFSI can be considered a promising
therapy for VFNs and could be used as an alternative to surgery in selected cases.
