Contact Ulcer and Granuloma
Module Summary
Vocal process granuloma/ contact ulcers are diagnosed based on clinical criteria using fiberoptic laryngoscopy. These lesions are initiated by injury to the mucosal lining over the vocal process by endotracheal intubation or phonotrauma, and are perpetuated by active laryngopharyngeal reflux disease. Successful treatment involves aggressive anti-reflux treatment with PPIs, inhaled corticosteroids, and in some cases speech therapy and/or vocal fold augmentation. Full resolution of these lesions may take months, especially in the case of non-intubation granulomas. Surgical treatment of these lesions may be indicated if malignancy is suspected or impending airway obstruction is present.
Module Learning Objectives
- Explain the risk factors for the development of contact ulcers and vocal process granulomas (VPGs).
- Confidently identify VPGs with the appropriate diagnostic evaluation.
- Review the appropriate treatment algorithm for VPGs.