Lamas MP, Zubiaur GFM

Language: Spanish
References: 18
Page: 7-15
PDF size: 245.59 Kb.

ABSTRACT

Objective: To determine the percentage of patients with laryngeal contact granuloma whose symptoms subside after the injection of botulinum toxin as monotherapy.
Materials and Methods: Cross-sectional, retrolective study was done with the records of Clínica de la Voz México from May 2012 to May 2018. Patients with laryngeal contact granuloma treated with botulinum toxin type A as monotherapy were included.
Results: Nine participants diagnosed with contact laryngeal granuloma and treated with botulinum toxin type A with a mean age of 47 ± 9.0 years were recruited, predominantly male (n = 7). A percutaneous approach assisted with electromyography was used, administering a toxin dose ranging from 2-6 units per vocal fold. After treatment, 6/9 participants reported having a weak voice of mild intensity, while 3/9 described it as moderate. The average recovery time was 19.5 ± 5.5 days. Complete relieve of symptoms was achieved in all participants, with a median of 5 weeks and with an interquartile range (IQR) of 3 to 6.5.
Conclusions: Due to the complete relieve of symptoms after the injection of botulinum toxin type A to the vocal folds, the mild side effects reported, as well as the fewer number of injections compared to other medications, botulinum toxin type A as monotherapy is an effective and safe treatment for laryngeal contact granuloma.

REFERENCES

1. Ettori J, D'Onghia A, Pignataro L, Cantarella G. Giant laryngeal granuloma developed after a severelystressful life event. Clin Case Rep 2020; 8 (12): 3628-9. doi: 10.1002/ccr3.3387.

2. Lemos EM, Sennes LU, Imamura R, Tsuji DH. Vocal process granuloma: clinical characterization, treatmentand evolution. Braz J Otorhinolaryngol 2005; 71 (4): 494-8. doi: 10.1016/s1808-8694(15)31205-2.

3. Martins RHG, Dias NH, Soares CSP, Gramuglia ACJ. Treatment of laryngeal granulomas. Int Arch Otorhinolaryngol 2019; 23 (3): E322-E4. doi: 10.1055/s-0039-1688456.

4. Shoffel-Havakuk H, Halperin D, Yosef L, Feldberg E, Lahav Y. Lesions of the posterior glottis: clinicaland pathologic considerations and treatment outcome. J Voice 2014; 28 (2): 263.e1-.e8. doi: 10.1016/j.jvoice.2013.08.013.

5. Farwell DG, Belafsky PC, Rees CJ. An endoscopic grading system for vocal process granuloma. J LaryngolOtol 2008; 122 (10): 1092-5. doi: 10.1017/S0022215108001722.

6. Shoffel-Havakuk H, Sadoughi B, Sulica L, Johns MM. In-office procedures for the treatment of benign vocalfold lesions in the awake patient: A contemporary review. Laryngoscope 2019; 129 (9): 2131-8. doi: 10.1002/lary.27731.

7. Kraimer KL, Husain I. Updated medical and surgical treatment for common benign laryngeal lesions. Otolaryngol Clin North Am 2019; 52 (4): 745-757. doi: 10.1016/j.otc.2019.03.017.

8. De Lima Pontes PA, De Biase NG, Gadelha EC. Clinical evolution of laryngeal granulomas: treatment andprognosis. Laryngoscope 1999; 109 (2 Pt 1): 289-94. doi: 10.1097/00005537-199902000-00021.

9. Roh HJ, Goh EK, Chon KM, Wang SG. Topical inhalant steroid (budesonide, Pulmicort nasal) therapy inintubation granuloma. J Laryngol Otol 1999; 113 (5): 427-32. doi: 10.1017/s0022215100144147.

10. Nie Q, Li JR, Zou SZ, Zhang R. Comparison of PPI and combined treatment in the treatment of recurrentlaryngeal contact granuloma. Am J Otolaryngol 2021; 42 (1). https://doi.org/10.1016/j.amjoto.2020.102766.

11. Zhang R, Li JR, Nie Q, Wu MK, Jia YY. Short-term outcome of transcutaneous glucocorticoid injection forlaryngeal contact granuloma in females. Eur Arch Oto-Rhino-Laryngol 2021; 278 (5): 1499-504.

12. Koufman JA, Rees CJ, Frazier WD, Kilpatrick LA, Wright SC, Halum SL, et al. Office-based laryngeal lasersurgery: a review of 443 cases using three wavelengths. Otolaryngol Head Neck Surg 2007; 137 (1): 146-51.doi: 10.1016/j.otohns.2007.02.041.

13. Ylitalo R, Lindestad PA. A retrospective study of contact granuloma. Laryngoscope 1999; 109 (3): 433-6. doi:10.1097/00005537-199903000-00017.

14. Yılmaz T, Kayahan B, Günaydın R, Kuşçu O, Sözen T. Botulinum toxin A for treatment of contact granuloma.J Voice 2016; 30 (6): 741-3. doi: 10.1016/j.jvoice.2015.07.015.

15. Fink DS, Achkar J, Franco RA, Song PC. Interarytenoid botulinum toxin injection for recalcitrant vocalprocess granuloma. Laryngoscope 2013; 123 (12): 3084-7. doi: 10.1002/lary.23915.

16. Damrose EJ, Damrose JF. Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma. JLaryngol Otol 2008; 122 (8): 824-8. doi: 10.1017/S0022215107000710.

17. Hamdan AL, Khalifee E, Jaffal H, Ghanem A. Interarytenoid botulinum toxin A injection for the treatmentof vocal process granuloma. J Laryngol Otol 2019; 133 (12): 1041-5.

18. Pham Q, Campbell R, Mattioni J, Sataloff R. Botulinum Toxin injections into the lateral cricoarytenoidmuscles for vocal process granuloma. J Voice 2018; 32 (3): 363-6. doi: 10.1016/j.jvoice.2017.06.006.