The Added Value of Steroid Injection Following Office-based Blue Laser Therapy of Benign Lesions of the Vocal Folds; Short-Term Effect in a Cohort of 43 Patients

Abstract

To investigate the added value of steroid injection following office-based blue laser therapy of benign lesions of the vocal folds. Retrospective cohort analysis. The medical records and video-recordings of patients with benign lesions of the vocal folds who underwent office-based blue laser therapy in a tertiary referral center between February 2020 and October 2022 were reviewed. Patients were divided into two subgroups, those who underwent office-based blue laser therapy alone (n=23) and those who underwent office-based blue laser therapy with steroid injection (n=19). Disease regression and voice outcome measures included Voice Handicap Index-10 score, perceptual voice evaluation using the GRB grading, jitter, shimmer, noise to harmonic ratio, voice turbulence index, and maximum phonation time were reviewed. A total of 42 patients were included. The mean age was 54.7 ± 10.1 years. Lesions included polyps (n=21), Reinke's edema (n=19), and cysts (n=2). There was partial or complete disease regression in all patients who presented for follow-up (n=37). In patients who underwent blue laser therapy alone (n=19), 42.1% had complete regression and 57.9% had partial regression. In those who underwent blue laser therapy followed by steroid injection (n=18), 77.7% had complete disease regression and 22.3% had partial regression. The difference in disease regression between the two subgroups was statistically significant (P=0.027). The decrease in the mean Voice Handicap Index-10 score was also statistically significant with a higher mean being noted in the subgroup who underwent blue laser therapy followed by steroid injection (-10.5 ± 6.9 vs. -17.3 ± 11.8, P=0.031). There was no significant difference in the decrease in the perceptual evaluation scores nor in the decrease in jitter, shimmer, noise to harmonic ratio, and voice turbulence index between the two subgroups. There was also no significant increase in the maximum phonation time. Steroid injection after blue laser therapy improves disease regression and voice outcome of laser therapy.