대한후두음성언어의학회지 (Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics)

  • 제33권3호
  • /
  • Pages.166-171
  • /
  • 2022
  • /
  • 2508-268X(pISSN)
  • /
  • 2508-5603(eISSN)
대한후두음성언어의학회 (The Korean Society of Laryngology, Phoniatrics and Logopedics. )
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후두 미세수술 중 병변 내 스테로이드 주입이 음성에 미치는 효과 분석

Analysis of the Effect of Intralesional Steroid Injection on the Voice During Laryngeal Microsurgery

  • 박재선 (성균관대학교 의과대학 강북삼성병원 이비인후과학교실) ;
  • 강현석 (성균관대학교 의과대학 강북삼성병원 이비인후과학교실) ;
  • 이인범 (성균관대학교 의과대학 강북삼성병원 이비인후과학교실) ;
  • 진성민 (성균관대학교 의과대학 강북삼성병원 이비인후과학교실) ;
  • 이상혁 (성균관대학교 의과대학 강북삼성병원 이비인후과학교실)
  • Jae Seon, Park (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Hyun Seok, Kang (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • In Buhm, Lee (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sung Min, Jin (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sang Hyuk, Lee (Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2022.08.01
  • 심사 : 2022.10.19
  • 발행 : 2022.12.31
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초록

Background and Objectives Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality. Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke's edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed. Results There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke's edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results. Conclusion There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.

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참고문헌

  1. Woo P, Casper J, Colton R, Brewer D. Diagnosis and treatment of persistent dysphonia after laryngeal surgery: A retrospective analysis of 62 patients. Laryngoscope 1994;104(9):1084-91.
  2. Schweinfurth JM, Ossoff RH. Current endoscopic treatment of dysphonia. Diagn Ther Endosc 2000;6(2):87-90. https://doi.org/10.1155/DTE.6.87
  3. Branski RC, Verdolini K, Sandulache V, Rosen CA, Hebda PA. Vocal fold wound healing: A review for clinicians. J Voice 2006;20(3):432-42. https://doi.org/10.1016/j.jvoice.2005.08.005
  4. Campagnolo AM, Tsuji DH, Sennes LU, Imamura R. Steroid injection in chronic inflammatory vocal fold disorders, literature review. Braz J Otorhinolaryngol 2008;74(6):926-32. https://doi.org/10.1016/S1808-8694(15)30155-5
  5. McCoy BJ, Diegelmann RF, Cohen IK. In vitro inhibition of cell growth, collagen synthesis, and prolyl hydroxylase activity by triamcinolone acetonide. Proc Soc Exp Biol Med 1980;163(2):216-22. https://doi.org/10.3181/00379727-163-40750
  6. Campagnolo AM, Tsuji DH, Sennes LU, Imamura R, Saldiva PH. Histologic study of acute vocal fold wound healing after corticosteroid injection in a rabbit model. Ann Otol Rhinol Laryngol 2010;119(2): 133-9. https://doi.org/10.1177/000348941011900211
  7. Lee SH, Yeo JO, Choi JI, Jin HJ, Kim JP, Woo SH, et al. Local steroid injection via the cricothyroid membrane in patients with a vocal nodule. Arch Otolaryngol Head Neck Surg 2011;137(10):1011-6. https://doi.org/10.1001/archoto.2011.168
  8. Nam W, Noh SH, Lee J, Kim SW, Jin SM, Lee SH. The effect of vocal fold steroid injection via cricothyroid membrane in patients with vocal polyp. Korean J Otorhinolaryngol-Head Neck Surg 2020;63(11): 511-6. https://doi.org/10.3342/kjorl-hns.2019.00507
  9. Nam W, Kim SW, Jin SM, Lee SH. The efficacy of percutaneous steroid injection via cricothyroid membrane for Reinke's edema. J Korean Soc Laryngol Phoniatr Logop 2019;30(2):101-6. https://doi.org/10.22469/jkslp.2019.30.2.101
  10. Cho JH, Kim SY, Joo YH, Park YH, Hwang WS, Sun DI. Efficacy and safety of adjunctive steroid injection after microsurgical removal of benign vocal fold lesions. J Voice 2017;31(5):615-20. https://doi.org/10.1016/j.jvoice.2017.01.003
  11. Hsu YC, Liao LJ, Huang TW, Wang CT. Assessment of patient outcomes after adjuvant vocal fold steroid injection for fibrosis after microlaryngeal surgery. JAMA Otolaryngol Head Neck Surg 2019;145(9): 811-6. https://doi.org/10.1001/jamaoto.2019.1682
  12. Woo SH, Jeong HS, Kim JP, Koh EH, Lee SU, Jin SM, et al. Favorable vocal fold wound healing induced by platelet-rich plasma injection. Clin Exp Otorhinolaryngol 2014;7(1):47-52. https://doi.org/10.3342/ceo.2014.7.1.47
  13. Hong SJ, Lee SH, Jin SM, Kwon SY, Jung KY, Kim MK, et al. Vocal fold wound healing after injection of human adipose-derived stem cells in a rabbit model. Acta Otolaryngol 2011;131(11):1198-204. https://doi.org/10.3109/00016489.2011.599816
  14. Jin HJ, Lee SH, Lee SU, Lee HS, Jin SM, Kim DH, et al. Morphological and histological changes of rabbit vocal fold after steroid injection. Otolaryngol Head Neck Surg 2013;149(2):277-83. https://doi.org/10.1177/0194599813489657
  15. Gilbert HR, Weismer GG. The effects of smoking on the speaking fundamental frequency of adult women. J Psycholinguist Res 1974; 3(3):225-31. https://doi.org/10.1007/BF01069239