الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
VFLs are non-malignant tissue growths of the vocal folds. The most common of these lesions are MAPLs, including VF nodules, polyp, cysts, vocal process granulomas, and RE; they represent about 50% of clinical voice disorders. The main cause of MAPLs currently appears to be vibratory trauma caused by vocal abuse or misuse. They have common predisposing factors as chronic infections of the upper airway, allergy, smoking, and GERD.
MAPLs are common in professional voice users and usually of common clinical presentations as dysphonia, reduction of loudness, pitch breaks, voice fatigue, dryness, and narrowed vocal range. Dysphonia affects the QOL, affecting the patients‘ physical, emotional, social, and economic status. As patients with MAPLs often have voice-related occupations, selecting the proper and effective treatment is very important.
Management of BVFLs is multidisciplinary with medical, behavioral, and potentially surgical. Some patients find difficulty with voice therapy as it requires voice rest and regular attendance of sessions. MLS is generally recommended for the treatment of BVFLs, but it has many adverse effects which may be unsuitable for some patients.
The rationale for glucocorticoid use in laryngology is likely related to the concept that many laryngeal disorders result from an abnormal inflammatory response following trauma (phonotrauma, iatrogenic, and/or phono microsurgical). Compared with available routes of administration of corticosteroids, direct steroid injection has the advantage of maintaining a higher regional drug concentration with minimal systemic adverse effects, especially if the dose is thoroughly
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