The outcomes of local betamethasone injection in treatment of vocal fold minimal associated pathological lesions

Abstract Background Minimal associated pathological lesions (MAPLs) are nonneoplastic vocal fold lesions that lie between organic benign and nonorganic voice disorders. Their management varies according to lesion type and size, ranging from voice therapy to microlaryngeal surgery. Office-based intralesional steroid injection (ILSI) has emerged as a minimally invasive therapeutic option with promising outcomes. Objective The present study aimed to evaluate short-term voice and lesion-related outcomes following intralesional steroid injection in patients with vocal fold MAPLs. Patients and methods This prospective interventional case series included 36 patients aged 18–65 years diagnosed with MAPLs (vocal fold nodules, polyps, cysts, Reinke’s edema, or contact granulomas) presenting with dysphonia. Diagnosis was confirmed by rigid laryngoscopy. All patients underwent office-based ILSI under local anesthesia via a percutaneous cricothyroid approach with transnasal flexible fiber-optic laryngoscopic monitoring. Outcome measures included video-laryngoscopic lesion assessment, Voice Handicap Index-10 (VHI-10), perceptual voice evaluation, and selected acoustic parameters. Follow-up assessment was conducted 3 weeks post-injection. Results At follow-up, complete lesion disappearance was observed in 41.7% of cases, while partial regression occurred in another 41.7%; no change was noted in 16%. Statistically significant improvement was demonstrated in total VHI-10 scores ( P < 0.05). Significant short-term changes were also noted in selected acoustic voice parameters following ILSI. Conclusion Office-based ILSI may represent a feasible alternative treatment option for selected cases of vocal fold MAPLs, particularly in patients who are not suitable for surgery, with encouraging early outcomes.