Đánh giá kết quả điều trị polyp dây thanh bằng phẫu thuật kết hợp với tiêm corticoid tại chỗ

Abstract

Objectives: Describe the clinical characteristics and laryngostroboscopy of vocal cord polyps. Assessment the results of vocal cord polyps surgery combined with local corticoid injection by using perceptual evaluation of voice scales and laryngostroboscopy.

Methods: Prospective studies describe cases 70 patients were identified vocal cord polyps at the Department of Ear Nose Throat - Bach Mai Hospital (07/2022– 06/2023).

Results: The most common age group is 21 - 60 years old (90%), female/male ratio: 1.13/1, hoarseness (100%). Common lesions on the vocal cords: edema, erythmatous (100%), mucosal wave decrease (100%), amplitude decrease (100%), 100% the vocal cords are not straight, no close glottis, constraction (58,6%). At the time of 3 months after surgery: VHI scale before surgery averaged 22 points, after surgery it decreased to 8 points. GRBAS scale for severe voice disorder was 15.8%; average 47.1%; After surgery, 88.6% of patients' voices returned to normal, mild 10%, average 1.4%, severe 0%. Analyze sound quality with local Jitter index: average value reduced from 0.86%; after surgery down to 0.23% the difference is statistically significant with p < 0.05. Shimmer index: average value decreased from 6.1%; after surgery decreased to 1.31% the difference is statistically significant with p < 0.05. HNR index: The average value of HNR before surgery treatment was 16.92 dB, increasing 23.78 dB after surgery the difference is statistically significant with p < 0.05. In the vocal cords with polyp, the state of mucosal edema and erythmatous was significantly reduced to only (7.1%), normal mucosal wave (92.9%), normal amplitude (94.3%), the free edge is straight and soft (94,3%), closed glottis (97.1%), closed glottis (97.1%), contraction (7.1%). In the vocal cords with no polyp, the state of mucosal edema and erythmatous was significantly reduced to only (2,9%), normal mucosal wave (100%), normal amplitude (100%), the free edge is straight and soft (100%), closed glottis (97.1%), contraction (7.1%). There were no cases with laryngeal web, vocal cord scarring. Local corticoid injection into the vocal cord with polyps and the vocal cords with no polyp has anti-inflammatory effects and reduces the regeneration of fibroblasts, helping to recover mucosal waves and amplitude, reducing erythmatous, avoiding laryngeal web and vocal cord scarring. Assess the result: 90% good.

Conclusion Vocal cord polyps surgery combined with local corticoid injection is a very valuable method in treating vocal cord polyps with high efficiency and few side effects. This method should be universal spacious facilities ENT specialist.