• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.1
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• pp.49-52
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• 2006

Background and Objectives: Vocal cord granuloma is a exophytic inflammatory mass and caused by gastroesophageal reflux, voice abuse, endotracheal intubation. There has been a controversy in the treatment of vocal cord granuloma. Our aim of study is to know the clinical characteristics and the results of surgical management for vocal cord granuloma. Materials and Methods: We have reviewed and analyzed medical records of 55 patients who were diagnosed and surgically treated as vocal cord granuloma in Asan medical center from 1997 to 2005 retrospectively. Results: 25 cases were intubation granuloma and 30 cases were contact granuloma. In intubation granuloma, the clinical manifestation was hoarseness(70%), foreign body sensation(44%), chronic cough(21%). In contact granuloma, the clinical manifestation was hoarseness(67%), foreign body sensation(60%), throat clearing(21%). The recurrence rate after surgery was 8% in intubation granuloma and 33% in contact granuloma. Mean recurrence time was 4.1months in intubation granuloma and 3.2months in contact granuloma. Conclusion: Although there is no significant difference, recurrence rate after surgery was high in contact granuloma compared to intubation granuloma(p=0.125). Although this study is retrospective, surgical management must be considered in resolving diagnostic doubt, treating airway obstruction, and failure in conservative treatments.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.417-421
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• 2007

Post-intubation granuloma of the larynx is a rare complication of general inhalation anesthesia, which is associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubations and endotracheal movement. This study was performed retrospectively to evaluate symptoms, incidence, duration and site for prevention of the intubation granuloma. The authors investigated 16 patients of intubation granuloma among 719 patients during 1 year period from August, 2005 to July, 2006 at the Department of Oral & Maxillofacial Surgery, Pusan National University Hospital. The results were as follows. 1. The incidence was 16/719 cases(2.2%) 2. The female to male ratio was 7:1 3. Hoarseness was the main symptom 4. Most cases occurred after 2-jaw orthognathic surgery.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.19-23
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• 2001

Background and Objectives： Larynx granuloma is a exophytic inflammatory mass and may result from gastroesophageal reflux disease and a traumatic or prolonged endotracheal intubation. There has been a controversy in the treatment of larynx granuloma. Our aim of study is to know the results of the conservative management and surgery for larynx granuloma. Materials and Methods : We have reviewed and analyzed medical records of 71 Patients who were diagnosed and treated as larynx granuloma in Asan medical center from 1989 to 2000 retrospectively. And questionnaires on present patient's status were answered via telephone. Results : Forty four cases were treated by conservative management and 29 cases were treated by surgery. The total Percentages of improvement after treatment were 85.7 o/o after conservative management and 75.9% after surgery. In intubation granuloma percentages of improvement were 86.4% after conservative management and 73% after surgery. In contact granuloma percentages of improvement were 85% after conservative management and 78.5% after surgery. Conclusion : Resolution and treatment periods are longer in contact granuloma compared to intubation granuloma in the groups of conservative management. (P＜0.05) There is no significant difference of their outcome between conservative management and surgery. (P＞0.05) Although this study is retrospective, conservative management is the first treatment in the management of larynx granuloma.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.133-137
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• 2013

Three patients who underwent orthognathic surgery under general anesthesia complained about difficulty in vocalization and hoarseness after surgery. Intubation granuloma was diagnosed by the department of otorhinolaryngology in our hospital and the masses were excised by laryngoscopy assisted surgery. Chief complaints and symptoms of patients were relieved after surgery. These cases report with review of articles is presented, and the etiology, diagnosis, treatment and prognosis of intubation granuloma after orthognathic surgery are evaluated.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.6
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• pp.375-378
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• 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 KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.2-87
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• 1976

Laryngeal granuloma following endotracheal anesthesia was reported as traumatic granuloma of the larynx by Clausen in 1932. Thereafter Harrison reported that 4% of the intubated cases developed larynx and upper respiratory tract injuries and 1% of the above mentioned injured cases later developed laryngeal granuloma with symptoms including voice change and even dyspnea in severe cases. The endotracheal intubation has been wedely used for general anesthesia or patency of the air way .and the reported cases of the laryngal granuloma Fig. 5. as its complication have been increased in number worldwidely. For a year from March 1975 to Feb. 1976, the authors have experienced the nine cases of laryngeal granuloma in our department and this is the report of clinical findings on these cases along with literature review.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.79-82
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• 2018

Background and Objectives : Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. Materials and Method : Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. Results : Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. Conclusion : Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.139-141
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• 2010

Pyogenic granuloma in larynx is very rare. It is benign disease, and histopathologically it looks like capillary-rich hemangioma. The most common etiology of pyogenic granuloma is laryngeal trauma, usually related to intubation. It can be treated with speech therapy, medication, or surgical resection. We experienced a case of large pyogenic granuloma in larynx with feeding vessels of a 24-year-old woman. When she visited us, she suffered from dyspnea. We had performed excision of laryngeal mass by laryngeal microsurgery emergently. She was diagnosed with pyogenic granuloma in larynx after operation.

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

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.185-187
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• 2000

The etiology of vocal fold granuloma was identified : post-endotracheal intubation, vocal abuse, acid reflux and idiopathic. The identification of the cause or causal factor is important, since the treatment must be fundamental directed at them. Treatment have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medical management. In this study, a case of vocal fold granuloma resolved who underwent injection of the affected vocal fold. Botulinum toxin type A is probably successful by decreasing the strength during adduction in the arytenoid region which, when very intense, would perpetuate the granuloma. Localized injection of this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy.