Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
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Treatment Results of Vocal Process Granuloma: Intubation Versus Contact Granuloma

삽관성 육아종과 접촉성 육아종에 대한 치료 결과 분석

  • Jeong, Jin Uk (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Oh, Jae Hwan (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Kim, Seul (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Kim, Dong Young (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Woo, Joo Hyun (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center)
  • 정진욱 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 오재환 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 김슬 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 김동영 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 우주현 (가천대학교 의과대학 길병원 이비인후과학교실)
  • Received : 2021.12.02
  • Accepted : 2021.12.09
  • Published : 2021.12.31
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Abstract

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.

Keywords

References

  1. Hong-Gang D, He-Juan J, Chun-Quan Z, Guo-Kang F. Surgery and proton pump inhibitors for treatment of vocal process granulomas. Eur Arch Otorhinolaryngol 2013;270(11):2921-6. https://doi.org/10.1007/s00405-013-2527-8
  2. Wang CT, Lai MS, Lo WC, Liao LJ, Cheng PW. Intralesional steroid injection: An alternative treatment option for vocal process granuloma in ten patients. Clin Otolaryngol 2013;38(1):77-81. https://doi.org/10.1111/coa.12021
  3. Karkos PD, George M, Van Der Veen J, Atkinson H, Dwivedi RC, Kim D, et al. Vocal process granulomas: A systematic review of treatment. Ann Otol Rhinol Laryngol 2014;213(5):314-20.
  4. Ylitalo R, Ramel S. Extraesophageal reflux in patients with contact granuloma: A prospective controlled study. Ann Otol Rhinol Laryngol 2002;111(5 Pt 1):441-6. https://doi.org/10.1177/000348940211100509
  5. Leonard R, Kendall K. Effects of voice therapy on vocal process granuloma: A phonoscopic approach. Am J Otolaryngol 2005;26(2):101-7. https://doi.org/10.1016/j.amjoto.2004.08.010
  6. Martins RH, Branco A, Tavares EL, Iyomasa RM, Carvalho LR, Henry MA. Laryngeal and voice disorders in patients with gastroesophageal symptoms. Correlation with pH-monitoring. Acta Cir Bras 2012;27(11):821-8. https://doi.org/10.1590/S0102-86502012001100013
  7. Hillel AT, Lin LM, Samlan R, Starmer H, Leahy K, Flint PW. Inhaled triamcinolone with proton pump inhibitor for treatment of vocal process granulomas: A series of 67 granulomas. Ann Otol Rhinol Laryngol 2010;119(5):325-30. https://doi.org/10.1177/000348941011900509
  8. Rimoli CF, Martins RHG, Cataneo DC, Imamura R, Cataneo AJM. Treatment of post-intubation laryngeal granulomas: Systematic review and proportional meta-analysis. Braz J Otorhinolaryngol 2018;84(6):781-9. https://doi.org/10.1016/j.bjorl.2018.03.003
  9. 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. Laryngoscope 2014;124(5):1187-91. https://doi.org/10.1002/lary.24470
  10. McFerran DJ, Abdullah V, Gallimore AP, Pringle MB, Croft CB. Vocal process granulomata. J Laryngol Otol 1994;108(3):216-20. https://doi.org/10.1017/S0022215100126337
  11. Lee DH, Yoon TM, Lee JK, Lim SC. Surgical treatment outcomes of vocal process granuloma after endotracheal intubation. J Craniofac Surg 2018;29(4):e387-9.
  12. Havas TE, Priestley J, Lowinger DS. A management strategy for vocal process granulomas. Laryngoscope 1999;109(2 Pt 1):301-6. https://doi.org/10.1097/00005537-199902000-00023
  13. Wani MK, Woodson GE. Laryngeal contact granuloma. Laryngoscope 1999;109(10):1589-93. https://doi.org/10.1097/00005537-199910000-00008
  14. Roh HJ, Goh EK, Chon KM, Wang SG. Topical inhalant steroid (budesonide, Pulmicort nasal) therapy in intubation granuloma. J Laryngol Otol 1999;113(5):427-32. https://doi.org/10.1017/S0022215100144147
  15. Wang CP, Ko JY, Wang YH, Hu YL, Hsiao TY. Vocal process granuloma - A result of long-term observation in 53 patients. Oral Oncol 2009;45(9):821-5. https://doi.org/10.1016/j.oraloncology.2009.01.008
  16. Nasri S, Sercarz JA, McAlpin T, Berke GS. Treatment of vocal fold granuloma using botulinum toxin type A. Laryngoscope 1995;105(6):585-8. https://doi.org/10.1288/00005537-199506000-00005
  17. Damrose EJ, Damrose JF. Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma. J Laryngol Otol 2008;122(8):824-8. https://doi.org/10.1017/S0022215107000710
  18. Yilmaz T, Kayahan B, Gunaydin RO, Kuscu O, Sozen T. Botulinum toxin A for treatment of contact granuloma. J Voice 2016;30(6):741-3. https://doi.org/10.1016/j.jvoice.2015.07.015
  19. Yilmaz T, Suslu N, Atay G, Ozer S, Gunaydin RO, Bajin MD. Recurrent contact granuloma: Experience with excision and botulinum toxin injection. JAMA Otolaryngol Head Neck Surg 2013;139(6):579-83. https://doi.org/10.1001/jamaoto.2013.3186