Unusual Aetiology of Vocal Process Granuloma in a Child

Abstract

Background: Vocal cord granuloma commonly arises following trauma or irritation from endotracheal intubation and reflux disease. Other uncommon causes are granuloma following voice abuse and foreign body in the larynx. Vocal process granuloma has however not been reported following blunt anterior neck trauma.
 Case Presentation: We present a case of vocal cord granuloma following an anterior neck trauma. The patient is a seven year old boy who presented with persistent hoarseness and stridor post neck injury of three months duration. Systemic steroid has been used prior to presentation with temporary improvement. The direct laryngoscopy done under general anaesthesia revealed masses on both vocal processes, which were successfully excised surgically. There was total resolution of presenting complaints after surgery with no symptoms suggestive of recurrence six month post operation.
 Conclusion: Post intubation and laryngopharyngeal reflux disease are common causes of vocal process granuloma. However, there is need to suspect granuloma formation following blunt anterior neck trauma for immediate conservative management avoiding the need for surgical intervention when patient present with upper airway obstruction.