{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:21:39Z","timestamp":1790727699231,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,14]],"date-time":"2013-03-14T00:00:00Z","timestamp":1363219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Emerging literature has documented the effectiveness of intralesional steroid injection as an alternative treatment for benign vocal fold disorders. However, clinical application is frequently limited by the associated technical demands for adequate anesthesia and precise needle placement. This study investigated the applicability and effectiveness of the more practical and less technically demanding method of transnasal endoscopic steroid injection (TESI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study recruited 30 patients with vocal nodules and polyps. Dexamethasone was injected into the Reinke's space under local anesthesia via the operating channel of a transnasal flexible laryngoscope in an office setting. Treatment outcome were measured before, 1 month after, and 3 months after the injection, using videolaryngostroboscopy (VLS), maximal phonation time (MPT), 10\u2010item voice handicap index (VHI\u201010), acoustic analysis, and perceptual evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VLS examinations at 3 months post\u2010treatment demonstrated that vocal lesions of 10 and 19 patients were resolved or reduced, respectively. Objective measurements showed increased MPT and decreased VHI\u201010 (<jats:italic>P<\/jats:italic> &lt; .05 and <jats:italic>P<\/jats:italic> &lt; .01, respectively). Acoustic analysis revealed significant decrease in jitter and shimmer (<jats:italic>P<\/jats:italic> &lt; .05). Perceptual evaluation using the GRB (grade, roughness, breathiness) scale also showed improved voice quality (<jats:italic>P<\/jats:italic> &lt; .01). Treatment outcomes were similar between vocal nodules and polyps (<jats:italic>P<\/jats:italic> &gt; .05). Mild vocal hematoma occurred in three patients following TESI, but resolved spontaneously within 1 month.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TESI is a simple and practical office\u2010based treatment modality for benign vocal fold lesions, suitable for most otolaryngologists. Treatment outcomes showed significant subjective and objective improvements that were comparable to the results of other injection procedures reported in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.23715","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T04:11:41Z","timestamp":1363320701000},"page":"1464-1468","source":"Crossref","is-referenced-by-count":44,"title":["Transnasal endoscopic steroid injection: A practical and effective alternative treatment for benign vocal fold disorders"],"prefix":"10.1002","volume":"123","author":[{"given":"Chi\u2010Te","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Far Eastern Memorial Hospital Taipei Taiwan"},{"name":"Graduate Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"},{"name":"Oriental Institute of Technology Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u2010Shu","family":"Lai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"},{"name":"Center of Comparative Effectiveness Research National Center of Excellence for Clinical Trial and Research National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Jen","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Far Eastern Memorial Hospital Taipei Taiwan"},{"name":"Graduate Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"},{"name":"Oriental Institute of Technology Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu\u2010Chia","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Far Eastern Memorial Hospital Taipei Taiwan"},{"name":"Oriental Institute of Technology Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Wen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Far Eastern Memorial Hospital Taipei Taiwan"},{"name":"Oriental Institute of Technology Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200312000-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2003.07.003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(01)00041-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.06.744"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948709600622"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(92)90020-E"},{"key":"e_1_2_6_8_1","first-page":"125","article-title":"Wegener's granulomatosis: a case with laryngeal involvement","volume":"39","author":"Gulati SP","year":"1997","journal-title":"Indian J Chest Dis Allied Sci"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1808-8694(15)30155-5"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480310001321"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-003-0720-x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000231455.19183.8c"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.86"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.168"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2011.620620"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811434003"},{"key":"e_1_2_6_17_1","first-page":"311","article-title":"Clinical implementation of a multidimensional basic protocol for assessing functional results of voice therapy. 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