Ein Follow-up von Patienten mit laryngealem Kontaktgranulom

Abstract

A conservative approach (vocal rest, voice therapy, antibiotic treatment of infections and/or management of esophageal reflux) and microsurgery have been used to heal laryngeal contact granulomas. Unfortunately, recurrences have been found in most cases. In the present study we followed 45 patients after an initial diagnosis of a contact granuloma was made based on laryngoscopy and stroboscopy with video-documentation. All studies were conducted in the Department of Phoniatrics (University of Göttingen) during the past four years, with follow-ups made at 3 month-intervals up to 12 months after diagnosis. All patients were counselled using a focal psychosomatic approach. Follow-up was possible for 41 patients. Findings showed that 19 patients lost their contact granulomas completely without therapy, 12 of which occurred over a period to 13 months after diagnosis. Seven patients underwent microsurgery at their own requests, with 5 developing recurrences when compared with the first diagnosis, 15 patients still had a contact granuloma. Emotional strain in connection with specific personality traits seemed to operate as a significant variable in the remission of contact granulomas.

Vocal process granuloma: clinical characterization, treatment and evolution

“…Clinical treatment of vocal process granuloma, according to the literature, may include empirical treatment for RLF, inhaled corticoids and speech therapy 6 , 9 , 10 , 11 . As to control of RLF, treatment with proton pump inhibitor (PPI) is more efficient than anti-histaminic H2 12 .…”

Vocal process granuloma

“…31 Other variables found to be highly associated with the presence of vocal process granulomas include low achievement orientation, fear of physical lesions, impulsiveness, low extraversion, high achievement orientation, fear of appearing in public, and strain. 32,33 Vocal trauma associated with distinctive personality types has been studied intensively. Vocal trauma associated with specific anatomic laryngeal abnormalities has not received the same attention.…”

Granuloma de processo vocal: caracterização clínica, tratamento e evolução

“…Speech therapy reduces hyperfunction, elevates the pitch up to comfortable level and increases the number of vocal inflections. These measures reduce the aggression to the arytenoid vocal process, allowing improvement of 46.7% of patients with granuloma 5,6,8,11 . In our study, the advocated clinical treatment initially used focused on empirically treat RLF and vocal abuse, regardless of identified etiopathogenic factors.…”

“…Patients with vocal abuse present low pitch, monotone voice, abuse of vocal fry, and hyperfunction, which would lead to further trauma in the vocal processes during phonation 8 . Clinical treatment of vocal process granuloma, according to the literature, may include empirical treatment for RLF, inhaled corticoids and speech therapy 6,[9][10][11] . As to control of RLF, treatment with proton pump inhibitor (PPI) is more efficient than anti-histaminic H2 12 .…”