{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:41Z","timestamp":1790690861746,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":90,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to assess the efficacy and safety of steroid injections in patients with benign vocal fold lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Scopus, and Embase were searched from January 2000 through December 2025 using predefined terms for benign vocal fold pathology and steroid injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>We conducted a PRISMA\u2010guided systematic review and meta\u2010analysis of studies evaluating steroid injections for benign vocal fold lesions. Study selection and data extraction were performed independently by two reviewers. Study quality was assessed using NIH (cohort studies), JBI (case series), and RoB 2 (RCTs). Random\u2010effects meta\u2010analysis (DerSimonian\u2010Laird) was performed in OpenMeta[Analyst], with Freeman\u2010Tukey double arcsine transformation for proportional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen studies were included. Posttreatment VHI pooled mean was 17.585 (95% CI 10.61\u201024.55;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200997%), while VHI change was not statistically significant (\u22126.948; 95% CI \u221216.06 to 2.16;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998%), indicating substantial between\u2010study heterogeneity and limited certainty in pooled VHI effect estimates. MPT improved, with post\u2010treatment pooled mean 13.24\u2009seconds (95% CI 12.54\u201013.94;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200973%) and pooled change 1.81\u2009seconds (95% CI 1.10\u20102.52;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200971%). Complications were uncommon (1.5%;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Overall improvement was 92%, recurrence 15.2%, complete remission 42.5%, partial remission 39.6%, and no response 9.4%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Steroid injection was associated with high clinical improvement and low complication rates. However, VHI demonstrated substantial heterogeneity and inconsistent statistical significance across studies, limiting the robustness and generalizability of pooled quality\u2010of\u2010life estimates. These findings support steroid injection as a minimally invasive option in selected patients but highlight the need for standardized protocols and higher\u2010quality comparative trials to better define its effect on patient\u2010reported voice outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70307","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:04:43Z","timestamp":1790669083000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Steroid Injection in Patients With Benign Vocal Fold Lesions: A Meta\u2010Analysis and Meta\u2010Regression"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3796-5337","authenticated-orcid":false,"given":"Yousef M.","family":"Al\u2010Shammari","sequence":"first","affiliation":[{"name":"Ophthalmology Department AlBahar Ophthalmology Center, Ibn Sina Hospital, Ministry of Health Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bisher","family":"Albesher","sequence":"additional","affiliation":[{"name":"Otolaryngology (ENT) Department Jaber Al\u2010Ahmad Hospital, Ministry of Health Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Murad","sequence":"additional","affiliation":[{"name":"General Surgery Department Mubarak Al\u2010Kabeer Hospital, Ministry of Health Jabriya Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhari","family":"Altaher","sequence":"additional","affiliation":[{"name":"General Surgery Department Al\u2010Jahra Hospital, Ministry of Health Al Jahra Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah H.","family":"AlGhurair","sequence":"additional","affiliation":[{"name":"Kuwait Board of Otolaryngology (ORL), Kuwait Institute for Medical Specializations (KIMS) Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad S.","family":"Alawadhi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Jordan University of Science and Technology Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Alshemari","sequence":"additional","affiliation":[{"name":"Head of Otolaryngology Department Alorf Hospital Al Jahra Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"11","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1080\/00016489.2021.1995895","article-title":"Comparison of therapeutic effects of steroid injection by benign vocal fold lesion type","volume":"141","author":"Takahashi S","year":"2021","journal-title":"Acta 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