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Updated: Sep 23, 2025

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Thyroarytenoid botulinum toxin injection for refractory laryngeal contact granuloma
Yufei Pan1, Jinrang Li1, Jinhong Zhang2
1Department of Otolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510510, China.
Background:
Although there are many treatments for laryngeal contact granuloma (LCG), some patients still fail treatment. Botulinum toxin A injection vocal cords may be a salvage therapy.
Objectives:
To study the efficacy of thyroarytenoid botulinum toxin A injection for the treatment of refractory LCG.
Material And Methods:
From May 2021 to March 2022, 23 male patients with refractory idiopathic LCG were treated by injection of botulinum toxin A into the thyroarytenoid muscle via the thyrohyoid membrane approach. Inspiratory-phase laryngoscopy images were collected before treatment and 3 months after injection treatment. The lesion size was evaluated with the Farwell granuloma endoscopic grading system and Image J software.
Results:
The average age of 23 patients was 49 years. The dose of botulinum toxin injection ranged from 2.5 to 5 units. Three months after injection, 17 patients were cured, 2 patients showed marked improvement, and 4 patients did not experience any effect. The total efficacy rate was 82.61% (19/23), and no serious complications occurred. Almost all patients experienced hoarseness within one week after injection; they gradually recovered after one month, and their voice returned to baseline at 3 months.
Conclusions:
Thyroarytenoid botulinum toxin injection is an effective method for resolving refractory LCG.
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The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids,...

