This is an interesting paper that describes the use of intralesional steroid injections to treat vocal cord mucus retention cysts. The gold standard is microlaryngoscopy and excision of the lesion. In patients who may be unable to undergo surgery, this is touted as an alternative option. The rationale being that the steroid injection reduces the inflammation surrounding the cyst, which reopens the obstructed orifice of the mucus excretory duct. The intralesional steroid injection consisted of a 1:1 mixture of dexamethasone and triamcinolone. Of the patients, 84% had ‘significant’ resolution of the lesion at two months. This was compared to 42% of patients receiving conservative treatment (medical and voice therapy). Longer-term follow-up demonstrated a bimodal recurrence pattern ranging from three to seven months and over a year (12-43 months). The recurrence rate was 44% (short and long-term). Interestingly, alcohol consumption was a significant risk factor for cyst recurrence after steroid injection.

Intralesional steroid injection as an alternative treatment for 57 patients of vocal fold mucus retention cysts.
Wu PH, Cheng PW, Lin FC, Wang CT.
CLINICAL OTOLARYNGOLOGY
2018;43;1375-8.
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Serge Latis

Royal Darwin Hospital, Tiwi, Australia.

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