Q Pham1, R Campbell2, J Mattioni3, R Sataloff4. 1. Philadelphia College of Osteopathic Medicine, Department of Otolaryngology-Head & Neck Surgery, Rowland Hall-Graduate Medical Education, Philadelphia, Pennsylvania. Electronic address: Quangph@pcom.edu. 2. University of Ottawa, Department of Otolaryngology-Head & Neck Surgery, Ottawa, Ontario, Canada. 3. Philadelphia College of Osteopathic Medicine, Department of Otolaryngology-Head & Neck Surgery, Rowland Hall-Graduate Medical Education, Philadelphia, Pennsylvania. 4. Drexel University College Of Medicine, Department of Otolaryngology-Head & Neck Surgery, Philadelphia, Pennsylvania.
Abstract
OBJECTIVE: Contact granulomas are benign, exophytic inflammatory lesions of the larynx that typically arise on or near the vocal process of the arytenoid cartilage. The most common management options include voice therapy and antireflux pharmacotherapy, intralesional steroid injections, botulinum toxin injections, and surgical excision. In-office Botox injection into the lateral cricoarytenoid (LCA) muscle can be effective even for recurrent granulomas. STUDY DESIGN: This is a retrospective chart review and literature review. METHOD: We reviewed more than 400 charts and included two patients, who underwent in-office injection with botulinum toxin A into LCA muscles bilaterally, after previously failing both conservative and surgical management. RESULTS: Both cases showed significant improvement of the laryngeal granulomas after 6 months and a single botulinum toxin injection. Both cases were initially grade III granuloma that improved to grade I. CONCLUSIONS: In-office injection of botulinum toxin A targeting the LCA muscle appears to be a safe and effective treatment modality in refractory laryngeal granuloma.
OBJECTIVE: Contact granulomas are benign, exophytic inflammatory lesions of the larynx that typically arise on or near the vocal process of the arytenoid cartilage. The most common management options include voice therapy and antireflux pharmacotherapy, intralesional steroid injections, botulinum toxin injections, and surgical excision. In-office Botox injection into the lateral cricoarytenoid (LCA) muscle can be effective even for recurrent granulomas. STUDY DESIGN: This is a retrospective chart review and literature review. METHOD: We reviewed more than 400 charts and included two patients, who underwent in-office injection with botulinum toxin A into LCA muscles bilaterally, after previously failing both conservative and surgical management. RESULTS: Both cases showed significant improvement of the laryngeal granulomas after 6 months and a single botulinum toxin injection. Both cases were initially grade III granuloma that improved to grade I. CONCLUSIONS: In-office injection of botulinum toxin A targeting the LCA muscle appears to be a safe and effective treatment modality in refractory laryngeal granuloma.