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Related Experiment Videos

A management strategy for vocal process granulomas.

T E Havas1, J Priestley, D S Lowinger

  • 1Sydney Voice Clinic, Australia.

The Laryngoscope
|July 13, 2000
PubMed
Summary

Aggressive management of gastroesophageal reflux disease and speech therapy effectively treat vocal process granulomas, reducing recurrence. Surgery is reserved for diagnostic uncertainty or airway compromise.

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Area of Science:

  • Otolaryngology
  • Gastroenterology
  • Speech-Language Pathology

Background:

  • Vocal process granulomas present diagnostic challenges due to unclear pathogenesis and high recurrence rates.
  • Surgical excision alone often fails to address underlying causes, leading to persistent inflammation and recurrence.

Purpose of the Study:

  • To review the efficacy of aggressive gastroesophageal reflux management and speech therapy in treating vocal process granulomas.
  • To describe and assess an investigation and management protocol for vocal process granulomas.

Main Methods:

  • Retrospective review of 55 patients with 61 vocal granulomas treated at the Sydney Voice Clinic.
  • Analysis of patient data including reflux grading, investigations, treatment, and outcomes; literature review.

Main Results:

  • Gastroesophageal reflux disease (GERD) was present in 76% of patients with vocal granulomas.
  • Surgical excision had a 50% recurrence rate; however, aggressive antireflux therapy, lifestyle changes, and speech therapy achieved resolution and prevented recurrence.
  • Antireflux surgery was required in four patients, leading to complete granuloma resolution.

Conclusions:

  • Acid reflux is a significant factor in vocal process granuloma formation and recurrence.
  • Management should prioritize addressing both reflux and functional voice disorders.
  • Laryngeal surgery is indicated only for diagnostic clarification or acute airway obstruction.

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