Also called “contact ulcers,” granulomas are discrete lesions that occur on the back portion of the vocal fold where it attaches to the arytenoid cartilage. Symptoms include throat pain, throat clearing, and a change in voice.

Diagnosis involves collecting symptoms and a visualization of the vocal folds to find the granuloma lesion.

Treatment for granuloma depends upon the size of the lesion and the length of time it has been present. The contributing factors need to be controlled as surgery by itself will often result in the regrowth of the lesion in a short period of time. Initial treatment will require control of reflux as well as optimization of vocal hygiene with hydration and minimizing of coughing and throat clearing. Occasionally voice therapy will be necessary. For lesions that do not respond, as an alternative to surgery, in-office laser treatment or vocal fold botox injections may be successful.

Prognosis for a granuloma is excellent; provided the patient controls the contributing factor, the granuloma generally will go away in a few weeks or months.