Vocal Fold Scar Treatment: Decadron vs. Decadron + 5-Fluorouracil

Introduction: To assess clinical response from treatment of vocal fold scar with Dexamethasone 10 mg/mL (DEX) compared to Dexamethasone 10 mg/mL + 5-Fluorouracil (5-FU) (DEX-5FU) utilizing the Voice Handicap Index-10 (VHI-10).

Methods: A total of 45 patients seen in the outpatient Laryngology clinic were recorded in the final data set, 30 (12 female, 18 male) having received the DEX-5FU and 20 (9 female, 11 male) treated with DEX. 5 of these patients switched between DEX and DEX-5FU. Self-reported voice quality outcomes using the VHI-10 survey were collected just before the first injection, we followed the same protocol at each procedure visit and follow-up. VHI-10 score from time of first injection to maximal benefit was calculated and averaged for each intervention group.

Results: Treatment of vocal fold scarring with DEX (7.6 ± 6.5) or with DEX-5FU (7.7 ± 6.1) both result in VHI-10 reduction of 7 points. While the difference in effectiveness is not represented in the quantitative data, analysis is limited by the common utilization of DEX-5FU as a preparatory step for irregularities requiring further intervention. The minimal important difference (MID) of the VHI-10 has previously been determined to be a change equal to or greater than 6. Both DEX and DEX-5FU were found to have effects that resulted in reductions greater than 7 of VHI-10 scores, supporting clinically significant effectiveness of treatment.

Conclusions: Vocal fold scarring treatment with DEX or DEX-5FU both result in a clinically significant VHI-10 decrease.