Expert Consensus of China on Laryngeal Contact Granuloma: A Modified Delphi Study

This study aimed to convene experts engaged in the diagnosis and treatment of laryngeal contact granuloma (LCG) and form a consensus group to guide primary care and specialist physicians in managing the condition.

Twenty-three Chinese experts were invited to participate in the modified Delphi process to revise 16 statements regarding the definition, epidemiology, etiology, clinical manifestations, diagnosis, and treatment of LCG. Experts independently rated the statements on four dimensions: importance, scientific acceptability, availability, and feasibility. After three rounds of voting, a statement was considered to have reached consensus if at least 80% of experts gave it a score of ≥8 in each of the four evaluation categories (using a 9-point Likert scale).

After three rounds of voting, 87.5% of the statements were approved (N = 14/16). At present, laryngopharyngeal reflux and mechanical injuries such as excessive voice use are considered the main causes. LCG can be diagnosed by laryngoscopy, and biopsy is generally not required. Lifestyle modification is the foundation of treatment, and voice therapy helps patients recover and reduces recurrence. For those with poor conservative treatment outcomes, steroid injections into the lesion or botulinum toxin injections into the same side vocal cord can be considered. The recurrence rate of surgical treatment is high, and it is usually not the first-line treatment option.

Using a well-tested methodology, optimal practice statements regarding LCG have been established. This information can serve to guide primary care and specialist physicians in managing this condition.