Treatment Results of Vocal Process Granuloma: Intubation versus Contact Granuloma

Woo, Joo Hyun; Oh, Jae Hwan; Lim, Byung Woo; Kim, Dong Young

doi:10.1055/s-0043-1768205

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International Archives of Otorhinolaryngology

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Original Research • iao 27 (2) • Apr 2023 • https://doi.org/10.1055/s-0043-1768205 copy

Treatment Results of Vocal Process Granuloma: Intubation versus Contact Granuloma

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Contact granulomas (CGs) and intubation granulomas (IGs) are known to have different clinical manifestations despite having the same pathological features.

Objectives

The purpose of the present study was to analyze the treatment results for CG and IG and to obtain clinical information.

Methods

We retrospectively reviewed the medical records of patients diagnosed with vocal process granuloma (VPG) between January 2015 and December 2018. The patient’s age, sex, medical history, lesion size, lesion type, reflux finding score (RFS), response to treatment, duration of treatment, and follow-up period were compared.

Results

Eighteen patients with CG and 14 patients with IG were included in the study. The IG group had more female patients (p = 0.0009), showed better response to proton pump inhibitor (PPI) and steroid inhalation (SI) (p = 0.036), and had a shorter treatment period (p = 0.0029) than the CG group. Five patients who received botulinum toxin injections in their vocal cords had complete remission.

Conclusions

Compared with CG, IG was more responsive to treatment with PPI and SI and required a shorter duration of treatment.

Keywords
vocal cord; contact; intubation; proton pump inhibitor; botulinum

Factors		Contact	Intubation	P-value
Number	(n)	18	14
Age (years)	Mean (± SD)	53.9 (± 12.5)	44.1 (± 16.4)	0.2089
Age (years)	Median (range)	54 (27–72)	43 (21–72)
Gender	Male (n)	15	3	0.0009^* * P < 0.05 in chi-squared test.
Gender	Female (n)	3	11
Granuloma size	Small (n)	8	5
	Medium (n)	5	2	0.5148
	Large (n)	5	7
Granuloma type	Granulomatous (n)	15	14	0.2379
Granuloma type	Ulcerative (n)	3	0
Voice abuse	Yes (n)	6	0	1
	No (n)	12	0
Reflux finding score	Mean (± SD)	9.4 (± 2.2)	8.1 (± 1.6)	0.1311
	Median (range)	8.5 (5.75–13.25)	7.75 (5–10.25)

Results		Contact (n = 18)	Intubation (n = 14)	p-value
Medication result (n)	Responsive (CR/MI)	7 (4/3)	11 (11/0)	0.036^* * P < 0.05 in chi-squared test.
	Unresponsive (ST/PG)	11 (10/1)	3 (3/0)
	Odds ratio (95% CI)	0.1736 (0.03538–0.8518)
Duration of medication (months)	Mean (± SD)	3.3 (± 1.7)	2.0 (± 0.8)	0.0029^† † P < 0.05 in Mann–Whitney U test.
Duration of medication (months)	Median (range)	3 (2–9)	2 (1–3)
Cases of Botox injection (n)		3	2
Final result of treatment (n)	Responsive (CR/MI)	10 (7/3)	13 (13/0)	0.0443^* * P < 0.05 in chi-squared test.
	Unresponsive (ST/PG)	8 (7/1)	1 (1/0)
	Odds ratio (95% CI)	0.09615 (0.01027–0.9004)
Follow-up period (months)	Mean (± SD)	4.5 (± 2.5)	2.9 (± 1.8)	0.0259^* * P < 0.05 in chi-squared test.
Follow-up period (months)	Median (range)	4 (2–12)	2.5 (1–6)

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[1] Address for correspondence Joo Hyun Woo, MD, PhD, Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University, Gil Medical Center, ENT office, Namdong-daero 774 beon-gil 21, Namdong-gu, Incheon 21565, South Korea (e-mail: woojh@gilhospital.com).