Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T23:38:29.093Z Has data issue: false hasContentIssue false
  • English
  • Français

Topical inhalant steroid (budesonide, Pulmicort® nasal) therapy in intubation granuloma

Published online by Cambridge University Press:  29 June 2007

Hwan-Jung Roh ,
Eui-Kyung Goh ,
Kyong-Myong Chon  and
Soo-Geun Wang
Hwan-Jung Roh
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Eui-Kyung Goh
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Kyong-Myong Chon
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Soo-Geun Wang*
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
*
Address for correspondence: Soo-Geun Wang, M.D., Department of Otolaryngology, Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Pusan 602-739, Korea. Fax: 82-51-248-1248
Get access Rights & Permissions [Opens in a new window]

Abstract

Intubation granuloma of the larynx is an iatrogenic disease which is induced by endotracheal intubation. It has basically been managed by conservative medical treatment with observation. Surgical excision can be considered as a last resort due to the high recurrence rate which subjects the patients to repeated anaesthesia. The purpose of this study is to evaluate the therapeutic effect of topical steroid in intubation granuloma, comparing the results of conservative medical treatment with, or without, surgery (Group I, 14 patients) and inhalant therapy with topical budesonide (Group II, 20 patients).

In Group I, complete disappearance of granuloma occurred in six cases within a year (42.8 per cent) with conservative therapy only. Microlaryngeal surgery was performed on the eight cases of persisting granuloma after conservative therapy for a year, resulting in two cases of recurrence. In Group II, the granuloma disappeared completely in 85 per cent within six months and in 95 per cent within 12 months without any remarkable side-effects. We concluded that intubation granuloma of the larynx could be treated with topical inhalant steroid as the first choice of therapy rather than other medical treatment or surgical intervention.

Keywords

Intubation, endotrachealGranulomaDrug therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 5 , May 1999 , pp. 427 - 432
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Balestrieri, F., Watson, C. B. (1982) Intubation granuloma. Otolaryngologic Clinics of North America 15: 567–579.CrossRefGoogle ScholarPubMed
Barton, R. T. (1953) Observation on the pathogenesis of laryngeal granuloma due to endotracheal anesthesia. New England Journal of Medicine 248: 538–541.CrossRefGoogle ScholarPubMed
Benjamin, B., Croxson, G. (1985) Vocal cord granulomas. Annals of Otology, Rhinology and Laryngology 94: 538–541.CrossRefGoogle ScholarPubMed
Clausen, R. J. (1932) Unusual sequela of tracheal intubation. Proceedings of the Royal Society of Medicine 25: 1507.CrossRefGoogle ScholarPubMed
Elsamma, Y. E., Mossallam, I., El Khodary, A. F., Habeeb, A. Y. (1971) Laryngology and Otology 85: 939–946.CrossRefGoogle Scholar
Feder, R. J., Michell, M. J. (1984) Hyperfunctional, hyperacidic, and intubation granulomas. Archives' of Otolaryngology 110:582–584.CrossRefGoogle ScholarPubMed
Harari, P. M., Blatchford, S. J., Coulthard, S. W., Cassady, J. R. (1991) Intubation granuloma of the larynx: successful eradication with low-dose radiotherapy. Head and Neck 13: 230–233.CrossRefGoogle ScholarPubMed
Iwamura, S., Ooishi, K., Sawaki, S., Hirose, H. (1983) Granuloma in larynx posterior: etiology and treatment of idiopathic granuloma. Otologia Fukuoka 29: 776–782.Google Scholar
Johansson, S. A., Andersson, K. E., Brattsand, R., Gruvstad, E., Hedner, P. (1982) Topical and systemic glucocorticoid potencies of budesonide, beclomethasone dipropionate and prednisolone in man. European Journal of Respiratory Disease (Suppl 122): 74–82.Google ScholarPubMed
Katanos, N., Miro, R. E., Perez, A. M., Mir, A. X., Vidal, A. A. (1983) Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Critical Care Medicine 11: 362–367.CrossRefGoogle Scholar
Kawasaki, Y., Fukuda, H., Kawaida, M., Oki, K., Kita, K., Shiotani, A., Takatama, E., Makino, K. (1989) Beclomethasone dipropionate inhalation therapy for granuloma of the larynx. Otologia Fukuoka 35: 604–608.Google Scholar
Mygind, N. (1979) Nasal Allergy 2nd Edition, Blackwell Scientific Publications, Oxford, UK, pp 312–332.Google Scholar
Santos, P. M., Afrassiabi, A., Weymuller, E. A. (1994) Risk factors associated with prolonged intubation and laryngeal injury. Otolaryngology – Head and Neck Surgery 111: 453–459.CrossRefGoogle ScholarPubMed
Schlorf, R. A., Duvall, A. J. III (1969) Post-intubation granuloma of the larynx. Minnesota Medicine 52: 717–720.Google ScholarPubMed
Ward, P. H., Zwitman, D., Hanson, D., Berci, G. (1980). Contact ulcers and granulomas of the larynx: new insights into their etiology as a basis for more rational treatment. Otolaryngology – Head and Neck Surgery 88: 262–269.CrossRefGoogle ScholarPubMed