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Bilateral vocal process papillomas: report of a case
Douglas M Sidle1, G Kenneth Haines, Ken W Altman
1Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, 303 E. Chicago Ave., Searle 12-561, Chicago, IL 60611, USA.
Ear, Nose, & Throat Journal
|December 11, 2002
Summary
Bilateral vocal process lesions initially suspected as granulomas were surgically revealed to be squamous papillomas. This case highlights the importance of considering differential diagnoses in persistent laryngeal conditions.
Area of Science:
- Otolaryngology
- Laryngology
- Pathology
Background:
- Vocal process granulomas are benign lesions often associated with gastroesophageal reflux, intubation, and smoking.
- Differential diagnosis is crucial as symptoms can overlap with other laryngeal pathologies.
- Accurate diagnosis is essential for effective treatment planning.
Observation:
- A 65-year-old man presented with bilateral vocal process lesions.
- Risk factors included a history of gastroesophageal reflux, intubation, smoking, and oral squamous cell carcinoma.
- Initial medical management (proton-pump inhibitor, reflux precautions, voice therapy, hydration) was ineffective.
Findings:
- Surgical intervention revealed the lesions to be squamous papillomas, not granulomas.
- This case underscores the challenge in differentiating vocal process granulomas from squamous papillomas based on clinical presentation alone.
- Histopathological examination is definitive for diagnosis.
Implications:
- This case highlights the need for thorough investigation and consideration of alternative diagnoses when medical management fails.
- Accurate histopathological diagnosis is critical for appropriate treatment of vocal process lesions.
- Understanding the differential diagnosis aids in managing complex laryngeal conditions.