Efficacy of Intra-lesional Steroid Injection on Quality of Voice Outcome in Benign Vocal Fold Lesions: A Meta-Analytical Study

Background Benign vocal fold lesions (BVFLs), including Reinke’s edema, vocal nodules, cysts, polyps, serous pseudo-cysts, chorditis, varices/ectasia, scars, and vocal process granulomas, can cause voice changes, including reduced loudness and pitch range. The incidence and symptoms of BVFLs increase with occupational demand. Furthermore, BVFLs frequently occur in the working-age population, resulting in a significant negative impact on the patient’s daily life. Recently, vocal fold steroid injection (VFSI) has become more popular as an intermediate between conservative treatments and laryngeal microsurgery. The advantages of VFSI include minimal invasiveness, can be performed under local anesthesia, high treatment effect, repeatability, minimal risk of scarring, cost-effectiveness, and good patient tolerability. Objective The aim of this study is to systematically identify and measure the efficacy of Intra-lesional steroid injection in order to assess the quality voice outcome in cases of benign vocal fold lesions. Methods This is a meta-analytical study that included 13 studies, and the literature search was conducted during March 2024. Results This systematic review and meta-analysis of 13 studies with 658 patients evaluated the effectiveness of intra-lesional steroid injections for benign vocal fold lesions. The results showed a 77.8% overall improvement. Most patients received a single injection (86.2%), primarily with triamcinolone acetonide. Polyps and nodules were the most common lesions treated. High heterogeneity was observed in the studies, particularly in VHI scores. Follow-up ranged from 1 to 26 months, with a mean follow-up of 5.1 months and a mean voice rest period of 2.83 days. Conclusion This meta-analysis supports the efficacy of intra-lesional steroid injections (VFSI) in improving voice function for benign vocal fold lesions, with a 77.8% overall improvement and reduced Voice Handicap Index (VHI). However, observed heterogeneity and publication bias highlight the need for standardized treatment protocols and larger, long-term studies to optimize outcomes and better understand influencing factors like lesion type and steroid selection. Further clinical trials are essential to refine treatment strategies and ensure consistent patient benefits.