The Effect of Nasal Steroid Spray on Contact Granuloma of Larynx

BACKGROUND AND OBJECTIVES: Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. MATERIALS AND METHOD: Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. RESULTS: Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. CONCLUSION: Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.

Effectiveness of Proton Pump Inhibitor in the Treatment of Contact Granuloma

BACKGROUND AND OBJECTIVES: Contact granuloma is granulation tissue that occurs mainly in the vocal process of arytenoid cartilage. Among several etiological factors, gastric acid reflux is known to be an important cause. The aim of this study was to evaluate clinical characteristics of contact granuloma and analyze the effectiveness of proton pump inhibitor in the treatment of contact granuloma. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 40 patients who were treated with proton pump inhibitor (PPI) for contact granuloma from January 2011 to December 2015. Reflux finding score (RFS), reflux symptom index (RSI) and size of granuloma were evaluated before and after treatment serially to assess the effectiveness of proton pump inhibitor. RESULTS: Of 40 patients, 25 patients (62.5%) and 10 patients (25%) showed improvement and partial improvement of granuloma, respectively. Five patients showed no response. The mean times of partial improvement and improvement were 2.08±2.23 months and 4.60±2.77 months, respectively and mean duration of PPI treatment was 6.8±5.2 months. CONCLUSION: Proton pump inhibitors is effective in the treatment of contact granuloma.