Treatment Result of Proton Pump Inhibitor, Steroid Inhaler and Botulinum Tonxin Injection for Contact Granuloma

ABSTRACT

BACKGROUND AND OBJECTIVES: This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. SUBJECTS AND METHODS: Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. RESULTS: Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. CONCLUSION: The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.