الفهرس 
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Abstract
With increasing stress in day -to -day life, rising level of pollution and changing habits and life styles, Voice disorders are becoming more prevalent.
Traditional standard management of benign vocal fold lesions is voice therapy and avoidance of any activities leading to voice abuse. When conservative therapy is ineffective, resection by laryngeal microsurgery can be performed under general anesthesia.
A local steroid injection directly into the benign vocal fold lesions has recently come to the forefront as another treatment option. This technique has the advantage of sparing general anesthesia.
This study was designed to compare the voice outcome and patient satisfaction after local steroid injection into vocal fold for patients with short term dysphonia (less than 6 months) versus patients with long term dysphonia (more than 1 year), and to conduct an analysis of the safety and efficiency of percutaneous steroid injection (PCI) as an alternative treatment modality for benign vocal fold lesions in patients who refuse micro laryngeal surgery or voice therapy.
It was conducted in the E.N.T department at Kasr el Ainy and Beni-Suef hospitals, Cairo and Beni-Suef Universities during period from October 2016 to October 2018.
This study included a total of 80 patient aged between 18 to 60 years old at the time of the study, complaining of dysphonia due to MAPL.The patients were divided into two groups according to duration of dysphonia.
Steroid was injected in the vocal folds under local anesthesia evaluation was done using:
The Voice Handicap Index (VHI) is one of the most widely used tools for subjective evaluation of voice severity. It is easy to be used by the patient by answering some questions before and at the fourth week after injection.
Videostroboscopy was done before and at the second and fourth week after injection.
Voice recording, acoustic and aerodynamic analysis of the voice signals was collected by Computerized Speech Lab (CSL) before and at the fourth week after injection
The results of current study were as follows:
1- The females were seen to predominate over males.
2- Vocal folds nodules were seen to be the commonest benign voice disorder.
3- Teachers were seen to be the commonest group affected.
4- Voice abuse was seen to be the commonest cause of dysphonia.
5- The anterior third of vocal folds was seen to be the commonest site of MAPLs.
6- Bilateral lesion was seen to be the commonest of MAPLs.
7- The maneuver used was injection in office base under local anesthesia, the injection was completed smoothly with no complications were noted.
8- There was a significant reduction in VHI scores in group A post injection and no change in the post injection mean values of VHI scores of group B patients
9- There was a significant difference in VHI scores in group A pre & post injection than the pre & post injection mean values VHI scores of group B patients.
10- There was improvement in the patients of group (A) post injection when compared with post injection of group (B) follow up by videostroboscopy.
11- There was a significant difference in Jitter & shim & & HNR and MPT values in group A post injection and no change in the post injection mean values of Jitter & shim & & HNR and MPT of group B patients.
12- There was a significant difference in Jitter & shim & HNR and MPT in group A pre & post injection than the pre & post injection mean values Jitter & shim & HNR and MPT of group B patients.