Follow-up of patients with laryngeal contact granuloma

Abstract

A conservative approach (vocal rest, voice therapy, antibiotic treatment of infections and/or management of esophageal reflux) and microsurgery have been used to heal laryngeal contact granulomas. Unfortunately, recurrences have been found in most cases. In the present study we followed 45 patients after an initial diagnosis of a contact granuloma was made based on laryngoscopy and stroboscopy with video-documentation. All studies were conducted in the Department of Phoniatrics (University of Göttingen) during the past four years, with follow-ups made at 3 month-intervals up to 12 months after diagnosis. All patients were counselled using a focal psychosomatic approach. Follow-up was possible for 41 patients. Findings showed that 19 patients lost their contact granulomas completely without therapy, 12 of which occurred over a period to 13 months after diagnosis. Seven patients underwent microsurgery at their own requests, with 5 developing recurrences when compared with the first diagnosis, 15 patients still had a contact granuloma. Emotional strain in connection with specific personality traits seemed to operate as a significant variable in the remission of contact granulomas.