Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지
DOI QR코드

DOI QR Code

Surgical treatment of laryngeal contact granuloma

후두 접촉성 육아종의 수술적 치료

  • Yoo, Byung Joon (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Zheng, Tao (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Lee, Dong Won (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Song, Chang Myeon (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Ji, Yong Bae (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Tae, Kyung (Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine)
  • 유병준 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 타오정 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이동원 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 송창면 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 지용배 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 태경 (한양대학교 의과대학 이비인후-두경부외과학교실)
  • Received : 2017.10.31
  • Accepted : 2017.11.09
  • Published : 2017.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background and Objectives: Gastric acid reflux is known to be the most important cause of contact granuloma. Therefore, anti-gastric acid reflux medication has been used as the first line treatment although there are other treatment methods such as surgery or steroid injections. Actually, the role of surgery in the treatment of contact granuloma has not been established clearly. The purpose of this study was to evaluate the effectiveness of surgical treatment for contact granuloma. Materials and Methods: We retrospectively reviewed the medical records of 14 patients who were diagnosed with contact granuloma and treated with surgery from 2011 to July 2016 at Hanyang University hospital. Results: Of 14 patients, 9 (64.3%) were male and 5 (27.4%) were female. The mean age was 53.8 (${\pm}6.1$) years. The main symptoms were voice change followed by globus, dyspnea, and asymptomatic. Mean Reflux Finding Score (RFS) before surgery was 13.5 and mead Reflux Symptom Index (RSI) was 10.4. The causes of surgery were inadequate response to proton pump inhibitor (PPI) in 4 cases, airway obstruction with large granuloma in 8 cases, and differential diagnosis in 2 cases. Of 14 patients, recurrence occurred in 8 (53.3%) patients after surgery. In 8 recurrent cases, 5 patients showed complete remission and 3 patients showed partial remission with PPI medication. Conclusion: The role of surgery in the treatment of contact granuloma might be limited due to high recurrence rate.

Keywords

References

  1. Carroll TL, Gartner-Schmidt J, Statham MM, Rosen CA. Vocal process granuloma and glottal insufficiency: an overlooked etiology? The Laryngoscope. 2010;120:114-120. https://doi.org/10.1002/lary.21321
  2. Ylitalo R, Ramel S. Extraesophageal reflux in patients with contact granuloma: a prospective controlled study. Annals of Otology, Rhinology & Laryngology. 2002;111:441-446. https://doi.org/10.1177/000348940211100509
  3. Hong-Gang D, He-Juan J, Chun-Quan Z, Guo-Kang F. Surgery and proton pump inhibitors for treatment of vocal process granulomas. European Archives of Oto-Rhino-Laryngology. 2013;270:2921-2926. https://doi.org/10.1007/s00405-013-2527-8
  4. Wani MK, Woodson GE. Laryngeal contact granuloma. The Laryngoscope. 1999;109:1589-1593. https://doi.org/10.1097/00005537-199910000-00008
  5. Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). Journal of voice. 2002;16: 274-277. https://doi.org/10.1016/S0892-1997(02)00097-8
  6. Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). The laryngoscope. 2001;111:1313-1317. https://doi.org/10.1097/00005537-200108000-00001
  7. Lee SW, Hong HJ, Choi SH, Sun DI, Park YH, Lee BJ, et al. Comparison of treatment modalities for contact granuloma: a nationwide multicenter study. The Laryngoscope. 2014;124:1187-1191. https://doi.org/10.1002/lary.24470
  8. Karkos PD, George M, Van Der Veen J, Atkinson H, Dwivedi RC, Kim D, et al. Vocal process granulomas: a systematic review of treatment. Annals of Otology, Rhinology & Laryngology. 2014;123:314-320. https://doi.org/10.1177/0003489414525921
  9. Mortensen M, Woo P. Office steroid injections of the larynx. The Laryngoscope. 2006;116:1735-1739. https://doi.org/10.1097/01.mlg.0000231455.19183.8c
  10. Havas TE, Priestley J, Lowinger DS. A management strategy for vocal process granulomas. The Laryngoscope. 1999;109:301-306. https://doi.org/10.1097/00005537-199902000-00023
  11. De Lima Pontes PA, De Biase NG, Gadelha MEC. Clinical evolution of laryngeal granulomas: treatment and prognosis. The Laryngoscope. 1999;109:289-294. https://doi.org/10.1097/00005537-199902000-00021
  12. Jin YJ, Lee SJ, Lee WY, Jeong W-J, Ahn S-H. Prognostic factors for prediction of follow-up outcome of contact granuloma. European Archives of Oto-Rhino-Laryngology. 2014;271:1981-1985. https://doi.org/10.1007/s00405-014-2915-8
  13. Damrose E, Damrose J. Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma. The Journal of laryngology and otology. 2008;122:824. https://doi.org/10.1017/S0022215107000710
  14. Yilmaz T, Suslu N, Atay G, Ozer S, Gunaydin RO, Bajin MD. Recurrent contact granuloma: experience with excision and botulinum toxin injection. JAMA Otolaryngology-Head & Neck Surgery. 2013;139:579-583. https://doi.org/10.1001/jamaoto.2013.3186
  15. Lee JC, Wang SG. Management of vocal process granuloma. Korean Journal of Otolaryngology-Head and Neck Surgery. 2005;48:70-73.
  16. Yilmaz T, Kayahan B, Gunaydin RO, Kuscu O, Sozen T. Botulinum toxin A for treatment of contact granuloma. Journal of Voice. 2016;30:741-743. https://doi.org/10.1016/j.jvoice.2015.07.015