Vocal process granuloma - A result of long-term observation in 53 patients

Vocal process granulomas are benign lesions involved in the healing of posterior glottis injuries. Here, we report the results of our conservative treatment of vocal process granulomas. Fifty-three patients with 54 occurrences of granulomas between 1998 and 2007 were enrolled. All patients were observed without surgical excision or specific medications and regularly monitored with telescopic examinations until the granulomas disappeared. Data on age, sex, clinical presentation, prior history of intubation or gastroesophageal reflux, telescopic findings, management and clinical course were reviewed. There were 41 males and 12 females. The mean ages of granuloma occurrence were 48.1 years in men and 41.6 years in women (p=0.16). Symptoms included hoarseness in 42 patients, cough in 13 patients, lumping sensation in the throat in 15 patients and sore throat in 14 patients. Ten occurrences were stable during the follow-up period, and the other 44 (81%) achieved complete remission (mean period of 30.6 weeks). The remission patterns included progression and remission in 6 occurrences, slow remission in 22 and rapid remission in 16. The remission rate of granulomas was not significantly related to age (p=0.71), sex (p=0.43), prior intubation (p=0.71), acid reflux (p=0.47), unilateral/bilateral lesions (p=1.00) or granuloma size (p=0.46). The remission time was significantly shorter in patients with prior intubation (p=0.04), but not significantly associated with age (p=0.89), sex (p=0.87), acid reflux (p=0.91), unilateral/bilateral lesions (p=0.26) or granuloma size (p=0.96). Long-term observation has demonstrated that vocal process granulomas can be cured at high remission rates without implementing specific treatments.