Botulinum toxin: helpful adjunct to early resolution of laryngeal granulomas.

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 from adduction 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 A was injected into the affected thyroarytenoid to reduce adduction trauma. Video-stroboscopy was used 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.

• Authors: Joanne Pham, Sheng Yin, M Morgan, F Stucker, Cherie-Ann Nathan
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 118 Issue 10 Pg. 781-5 (Oct 2004) ISSN: 0022-2151 [Print] England
• PMID: 15550184 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Aged
• Botulinum Toxins, Type A (therapeutic use)
• Combined Modality Therapy (methods)
• Female
• Granuloma (drug therapy, surgery)
• Humans
• Laryngeal Diseases (drug therapy, surgery)
• Laryngoscopy
• Male
• Middle Aged
• Neuromuscular Agents (therapeutic use)
• Prospective Studies
• Recurrence
• Treatment Outcome