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Original Investigation |

Conservative Management for Vocal Fold Polyps

Woo-Jin Jeong, MD1; Sun Joo Lee, MD1; Won Yong Lee, MD1; Hyun Chang, MD1; Soon-Hyun Ahn, MD1
[+] Author Affiliations
1Department of Otorhinolaryngology–Head & Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
JAMA Otolaryngol Head Neck Surg. 2014;140(5):448-452. doi:10.1001/jamaoto.2014.243.
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Importance  Classically, surgery has been the mainstay of management for vocal fold (VF) polyps. However, a significant portion of patients experience spontaneous regression and may not require surgery.

Objectives  To report the results of conservative management for VF polyps, identify patients with polyps that are more likely to resolve, and describe the time course of resolution.

Design, Setting, and Participants  In this case series of 248 patients with VF polyps conducted presenting to a tertiary referral center, 94 patients were treated conservatively with at least 3 months of follow-up. All laryngoscopy photodocumentation and medical records were reviewed retrospectively.

Interventions  Conservative management with close follow-up.

Main Outcomes and Measures  Time course and resolution of VF polyps.

Results  Of 94 VF polyps, 43 (46%) showed a clinically significant reduction in size, and 36 (38%) resolved completely without requiring surgery. Multivariate analysis showed that VF polyps were most likely to resolve in female patients and in those with small-sized polyp and shorter symptom duration. Of the resolved polyps, 44% and 81% were resolved at 3 months and 8 months, respectively.

Conclusions and Relevance  Selected patients with VF polyp may benefit from conservative management, especially female patients and those with small, recent-onset polyps. The majority of polyps that resolve do so within 8 months, which can assist clinical decision making and counseling.

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Figure 1.
Definition of Polyp Size

A, Large (category 3); B, medium (category 2); C, small (category 1); D, resolved (category 0).

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Figure 2.
Categorization of Polyp According to Morphology and Color

A, Hemorrhagic; B, organized; C, translucent.

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Figure 3.
Temporal Representation of Resolution of Vocal Fold Polyps

Nearly half of the polyps that resolved did so within 3 months, and more than 80% of polyps that disappeared did so in 8 months. Only a small portion of polyps resolved after this time frame.

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Conservative management for vocal fold polyps. JAMA Otolaryngol Head Neck Surg 2014;140(5):448-52.
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