• Phonetics and Speech Sciences
• /
• v.2 no.4
• /
• pp.165-171
• /
• 2010

Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT$^{(R)}$, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.14 no.1
• /
• pp.40-46
• /
• 2003

Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.18 no.6
• /
• pp.375-378
• /
• 2018

Endotracheal intubation is commonly associated with laryngeal injury that often resolves spontaneously without any complication. However, stenosis or granulomatous lesions are generally found on the tracheal wall or vocal process at the tube cuff level, caused by excessive cuff pressure. We present a case of fatal vocal cord granuloma leading to dyspnea following orthognathic surgery and sustained intubation for 14 hours.

• Proceedings of the KSLP Conference
• /
• 2016.03a
• /
• pp.43-43
• /
• 2016

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.2
• /
• pp.123-127
• /
• 2017

Background and Objectives : Contact granuloma is granulation tissue that occurs mainly in the vocal process of arytenoid cartilage. Among several etiological factors, gastric acid reflux is known to be an important cause. The aim of this study was to evaluate clinical characteristics of contact granuloma and analyze the effectiveness of proton pump inhibitor in the treatment of contact granuloma. Materials and Methods : We retrospectively reviewed the medical records of 40 patients who were treated with proton pump inhibitor (PPI) for contact granuloma from January 2011 to December 2015. Reflux finding score (RFS), reflux symptom index (RSI) and size of granuloma were evaluated before and after treatment serially to assess the effectiveness of proton pump inhibitor. Results : Of 40 patients, 25 patients (62.5%) and 10 patients (25%) showed improvement and partial improvement of granuloma, respectively. Five patients showed no response. The mean times of partial improvement and improvement were $2.08{\pm}2.23$ months and $4.60{\pm}2.77$ months, respectively and mean duration of PPI treatment was $6.8{\pm}5.2$ months. Conclusion : Proton pump inhibitors is effective in the treatment of contact granuloma.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.2
• /
• pp.128-132
• /
• 2008

Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.32 no.3
• /
• pp.135-141
• /
• 2021

Background and Objectives Vocal process granulomas (VPGs) are benign lesions of the larynx, typically contact granulomas (CG) and intubation granulomas (IG). The two diseases are known to have different clinical manifestations despite having the same pathological features. The purpose of this study was to analyze the treatment results for CG and IG and to obtain clinical information. Materials and Method We retrospectively reviewed the medical records of patients diagnosed with VPG between January 2015 and December 2018. The patient's age, sex, medical history, lesion size, lesion type, reflux finding score, response to treatment, duration of treatment, and follow-up period were compared. Results In total, 32 patients were included in the study, of which 18 were CG and 14 were IG. In the CG group, males were dominant (n=15, 83.3%), whereas in the IG group, females were dominant (n=11, 78.6%) (p=0.0009). The response to medical treatment using proton pump inhibitor and steroid inhaler was better in the IG group (11/14, 78.6%) than in the CG group (7/18, 38.9%) (p=0.036). Of the 14 patients who did not respond to medical treatment, 5 received botulium toxin injections, and all 5 had complete remission. The duration of medical treatment was significantly longer in the IG group (p=0.0029). Conclusion IG was more common in female, and CG was more dominant in male. IG had better response to medical treatment using proton pump inhibitor and steroid inhaler than CG.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1993.05a
• /
• pp.76-76
• /
• 1993

Endotracheal intubation is common technique for general anesthesia or patency of airway. However, laryngeal intubation granuloma is the most common sequale of endotracheal intubation in otolaryngologic field. From 1982 to 1992, the authors had experienced 16 cases intubation granuloma. The following results were as follows; 1. Age distribution was mostly in the 20 to 49 years old group (84 %).The sex ratio of male to female was 1:7, predominantly in female. 2. Main sx. were hoarse in 12(75%), F.B. sensation in 3(18%), dyspnea in 1 (6%). 3. The side of lesion was bilateral in 6 cases (37%) and unilateral in 10 cases (63%). Unilateral had the 3 cases (30%) in left and the 7 cases (70%) in right. The location of mass was vocal process of arytenoid cartilage in 8 cases(50%), post 1/3 of vocal cord in 6 cases (37 %) and middle 1/3 of vocal cord in 2 cases (12 %). 4. The duration between extubation and onset of symptom in less than a month was most frequent in 7 cases (44 %) out of 16 cases. 5. The most common operation was cesarean section in 6 cases (37 %). 6. Mean duration of intubation time was 2 hour 5 minutes. 7. Composition of used intubation tube was red rubber tube. 8. One case (6 %) was recurred.