Intubation granuloma of the larynx: Successful eradication with low‐dose radiotherapy

Harari, Paul M.; Blatchford, Steven J.; Coulthard, Stanley W.; Cassady, J. Robert

doi:10.1002/hed.2880130312

Cited by 22 publications

(18 citation statements)

References 11 publications

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“…Harari et al in 1991 reported treatment of a multiply recurrent contact granuloma with 1200 cGy immediately after excision in a patient occupationally dependent on his voice. 63 No recurrence was noted with 3-year follow-up. It is noteworthy that before treatment with irradiation the patient had undergone six surgical excisions of a postintubation laryngeal granuloma during a 5-month interval.…”

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confidence: 89%

Vocal process granuloma

et al. 2001

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Management to diminish laryngopharyngeal reflux, as well as to correct vocally abusive behavior, will appropriately address the majority of vocal process granuloma. Surgical removal is best reserved for cases when conservative management fails, when airway obstruction is a concern, or when a biopsy is needed to establish the diagnosis. Ancillary measures that may be beneficial in specific cases include the use of steroids, antibiotics, membranous vocal fold augmentation, and laryngeal botulinum neurotoxin injection.

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confidence: 89%

Vocal process granuloma

et al. 2001

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“…5 Other forms of treatment have been proposed including antibiotics, corticosteroids, postexcision irradiation, and botulinum toxin A injection. 2,5,11,[12][13][14] Of these, botulinum toxin A injections have shown the most promise at the expense of a high incidence of symptomatic dysphagia and dysphonia during the treatment period due to the side effects from botulinum toxin A.…”

Section: Introductionmentioning

confidence: 99%

Vocal process granuloma and glottal insufficiency: An overlooked etiology?

Carroll¹,

Gartner‐Schmidt²,

Statham³

et al. 2009

The Laryngoscope

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Objectives/Hypothesis: Vocal process granuloma has been attributed to intubation, laryngopharyngeal reflux, and phonotraumatic/hyperfunctional vocal behaviors. Vocal process granuloma has recurrence rates following surgical excision approaching 92%. We hypothesize that a portion of persistent or idiopathic cases of vocal process granuloma result from underlying glottal insufficiency (GI) caused by paresis, scar, or atrophy. Our goal was to examine our vocal process granuloma population and determine the incidence of GI, treatment interventions, and outcomes.Study Design: Retrospective chart review. Methods: Thirty-four patients with vocal process granuloma were divided into surgically or conservatively managed groups. Patients were identified if they carried a diagnosis of GI. The time to resolution and number of recurrences within the overall treatment period was recorded and compared between subgroups. Pre-and post-treatment Voice Handicap Index-10 (VHI-10) and Reflux Symptom Index (RSI) scores were compared.Results: Eighteen of 34 patients (53%) carried an underlying diagnosis of GI, 13/34 (38%) were treated surgically, and 8/13 (62%) surgical patients had underlying GI. VHI-10 and RSI scores significantly improved after disease resolution (P < .05).Conclusions: The incidence of GI among patients with vocal process granuloma was 53%. Conservative therapies including treatment of laryngopharyngeal reflux and voice therapy may lead to resolution despite underlying glottal incompetence. If conservative measures fail, recognizing and treating glottal incompetence with true vocal fold augmentation may lead to a shorter surgical treatment course.

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“…3 When these conservative measures fail, laryngeal surgery (CO 2 laser, pulsed dye laser, cold excision, or cautery) is sometimes effective, and antibiotics, vocal fold augmentation, and laryngeal botulinum toxin injection may also have important roles in treatment. 1,[13][14][15][16] Botulinum toxin has been used to successfully treat vocal process granulomas based on the hyperadduction/hypermobility theory. 17,18 Augmentation of the vocal folds by injection laryngoplasty has also been used successfully in patients with vocal fold paresis and paralysis.…”

Section: Discussionmentioning

confidence: 99%