IMPORTANCE: Contact granuloma is a difficult-to-treat laryngeal disorder associated with vocal abuse, habitual throat clearing, and laryngopharyngeal reflux. It has a high propensity for persistence and recurrence despite many treatment alternatives. OBJECTIVE: To present our experience with recurrent contact granuloma treated with microlaryngoscopic excision and botulinum toxin injection. DESIGN: Case series. The follow-up period had a mean (range) of 41 (11-88) months. SETTING: Tertiary referral university clinic. PARTICIPANTS: Twenty patients with recurrent, grade 3 and grade 4 contact granuloma whose lesion was excised at least once after failure of conservative treatments. INTERVENTIONS: Microlaryngoscopic excision and botulinum toxin type A injection into the region of the bilateral thyroarytenoid and lateral cricoarytenoid muscles. MAIN OUTCOMES AND MEASURES: Disappearance of contact granuloma. RESULTS: Seventeen patients were cured of their contact granuloma. Three patients experienced recurrences: 2 received botulinum toxin injection only as outpatients and recovered. The other patient required reexcision and reinjection under general anesthesia. These 3 patients were free of granuloma at their last follow-up. CONCLUSIONS AND RELEVANCE: After failed conservative treatment, microlaryngoscopic excision and botulinum toxin type A injection is successful in the treatment of recurrent contact granuloma. Removing recurrent granulomas can result in a low recurrence rate if botulinum toxin type A is added at the time of removal.
IMPORTANCE: Contact granuloma is a difficult-to-treat laryngeal disorder associated with vocal abuse, habitual throat clearing, and laryngopharyngeal reflux. It has a high propensity for persistence and recurrence despite many treatment alternatives. OBJECTIVE: To present our experience with recurrent contact granuloma treated with microlaryngoscopic excision and botulinum toxin injection. DESIGN: Case series. The follow-up period had a mean (range) of 41 (11-88) months. SETTING: Tertiary referral university clinic. PARTICIPANTS: Twenty patients with recurrent, grade 3 and grade 4 contact granuloma whose lesion was excised at least once after failure of conservative treatments. INTERVENTIONS: Microlaryngoscopic excision and botulinum toxin type A injection into the region of the bilateral thyroarytenoid and lateral cricoarytenoid muscles. MAIN OUTCOMES AND MEASURES: Disappearance of contact granuloma. RESULTS: Seventeen patients were cured of their contact granuloma. Three patients experienced recurrences: 2 received botulinum toxin injection only as outpatients and recovered. The other patient required reexcision and reinjection under general anesthesia. These 3 patients were free of granuloma at their last follow-up. CONCLUSIONS AND RELEVANCE: After failed conservative treatment, microlaryngoscopic excision and botulinum toxin type A injection is successful in the treatment of recurrent contact granuloma. Removing recurrent granulomas can result in a low recurrence rate if botulinum toxin type A is added at the time of removal.
Authors: Elizabeth L Perkins; Saikat Basu; Guilherme J M Garcia; Robert A Buckmire; Rupali N Shah; Julia S Kimbell Journal: Otolaryngol Head Neck Surg Date: 2017-11-21 Impact factor: 3.497
Authors: Vojko Djukić; Sanja Krejović-Trivić; Milan Vukašinović; Aleksandar Trivić; Bojan Pavlović; Aleksandar Milovanović; Jovica Milovanović Journal: J Med Biochem Date: 2015-03-03 Impact factor: 3.402
Authors: Caroline Fernandes Rimoli; Regina Helena Garcia Martins; Daniele Cristina Catâneo; Rui Imamura; Antonio José Maria Catâneo Journal: Braz J Otorhinolaryngol Date: 2018-04-14