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KMID : 0384020080190020128
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Journal of the Korean Society of Logopedics and Phoniatrics
2008 Volume.19 No. 2 p.128 ~ p.132
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Management of Laryngeal Contact Granuloma
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Ko Moon-Hee
Son Young-Ik
Jang Jeon-Yeob
So Yoon-Kyoung
Chung Man-Ki
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Abstract
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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 (, N =26) were used as a first-line treatment. Among the non-responders to , 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 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.
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KEYWORD
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Laryngeal aranuloma, Treatment outcome, Gastroesophageal reflux
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