Vocal Fold Steroid Injection

In the modern era of minimally invasive surgery and in-office procedures, vocal fold steroid injection (VFSI) is a valuable and indispensable tool for phonosurgeons in their gearbox. Clinical indications include vocal nodules, polyps, mucus retention cysts, Reinke’s edema, scar, and postoperative fibrosis. With the advancement of endoscopic technology, VFSI can be easily performed via trans-oral, trans-nasal, and percutaneous approaches. Adequate laryngeal anesthesia is the key to a smooth procedure, which also requires continual practice and great patience. Most adverse events after VFSI, including hematoma, deposition of triamcinolone, and vocal atrophy, are self-limited without irreversible sequel. Careful and precise placement of needle superficial to vocal ligament, and injecting minimal amount of steroid helps to avoid these adverse events. Adjuvant voice therapy is encouraged to lower the recurrence rate after VFSI.