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Botulinum toxin: helpful adjunct to early resolution of laryngeal granulomas

Published online by Cambridge University Press:  08 March 2006

Joanne Pham ,
Sheng Yin ,
M. Morgan ,
F. Stucker  and
Cherie-Ann Nathan
Joanne Pham
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center at Shreveport, Louisiana, USA
Sheng Yin
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center at Shreveport, Louisiana, USA
M. Morgan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center at Shreveport, Louisiana, USA
F. Stucker
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center at Shreveport, Louisiana, USA
Cherie-Ann Nathan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center at Shreveport, Louisiana, USA
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Abstract

Treating laryngopharyngeal reflux is the most accepted treatment for laryngeal granulomas. However, response to this treatment is prolonged and in some cases persistent. The authors hypothesize that this is due to the continuous trauma to the mucoperichondrium fromadduction of the vocal folds thus preventing regeneration of healthy mucosa.

A prospective study was performed on six patients with laryngeal granulomas failing prolonged laryngopharyngeal reflux treatment, speech therapy, and surgical excisions. Botulinum toxin Awas injected into the affected thyroarytenoid to reduce adduction trauma. Video-stroboscopy wasused to assess response.

A 50 per cent reduction in the size of the granulomas was noted within two weeks with a complete and permanent response within two to eight weeks in five out of six patients. One patient had an obstructing pyogenic granuloma that required excision and recurred after excision but responded to a repeated injection.

The addition of a single injection of botulinum toxin A to the standard treatment expeditiously eliminated persistent and recurrent laryngeal granulomas.

Keywords

Botulinum ToxinsLarynxGranulomaTreatment Outcome
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 118 , Issue 10 , October 2004 , pp. 781 - 785
Copyright
© 2004 Royal Society of Medicine Press

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