Vocal Fold Granuloma

What is it?
Vocal fold granulomas are benign, reactive growths that develop from repeated collisional trauma (“phonotrauma”), direct trauma related to an endotracheal tube, acid reflux-related injury, or over-exuberant healing at a previous surgical site.  Vocal fold granulomas can be related to tension of the larynx during phonation, or muscle tension dysphonia (see below).  Granulomas of the vocal folds related to trauma are often located in the posterior portion of the larynx near an underlying structure call the arytenoid cartilage.  Symptomatic patients may describe a raspy voice or changes in pitch control or range.  Rarely, a large granuloma may affect swallowing or breathing.

How is it treated?
Vocal fold granulomas may resolve with voice rest and voice therapy to reduce muscle tension and repeated phonotrauma, reducing silent reflux with medical therapy, and often adding topical treatment with inhalation steroid therapy.  Some granulomas do not resolve with conservative measures or are quite large, which necessitate surgical removal.  At the Voice Clinic of Indiana, surgery can offered in either a clinic setting (under local anesthesia) or a traditional operating room setting (under general anesthesia).  Occasionally, steroid, inhaled steroid, or botulinum toxin is used as an adjunct to help treat vocal fold granulomas.