Direct Microlaryngoscopy and Excision of Vocal Cord Lesion
Seth M. Cohen, MD, MPH; C. Scott Brown, MD
Duke University Medical Center

Laryngeal granulomas present with clinical signs and symptoms including dysphonia, hoarseness, discomfort or pain in the throat, and dyspnea. Notably, vocal granuloma, despite its name, pathologically is not a true granulomatous process. Instead, it is characterized as a reactive/reparative process where intact or ulcerated squamous epithelium is underlaid by granulation tissue or fibrosis. Although granulomas are typically of benign nature, they often require surgical treatment. Other options for treatment include proton-pump inhibitors (PPIs) and steroid inhalations, botulinum neurotoxin injection, and phonotherapy. Nearly half of the cases usually remit through clinical management involving PPIs, topical inhalant steroids, and phonotherapy.