Contact granuloma

Contact granuloma, also known as a contact ulcer, is a condition where an ulcer is found in the vocal folds, on the mucous membrane of the posterior third of the vocal cord (vocal process) where the vocal ligament attaches. The most common cause of the condition is sustained periods of increased pressure on the vocal folds, and is commonly seen in people who use their voice excessively such as singers (John Mayer being the most recent notable case).^[1] Gastroesophageal reflux disease is also thought to be a contributing factor in the development of contact ulcers.

Symptoms

Chronic or acute hoarseness of the voice, vocal fatigue, and throat pain are the primary symptoms.

Diagnosis

Diagnosis of contact ulcers normally involves an endoscopy examination, and a biopsy sample is taken so that the ulcer can be examined for cancerous cells.

Treatment

If forceful speaking is the primary cause, treatment involves resting the vocal cords for as long as six weeks, normally followed by vocal therapy so that the patient can be taught how to correctly use the voice. Surgery is also done to remove the ulcers, but this is often considered a last resort as recurrence is common.

In cases where contact granuloma is caused by gastroesophageal reflux disease, treatment for it is often initiated.

Sources

• Contact Granuloma/Contact Ulcer - IntelliHealth
• Excerpt from Contact Granulomas - eMedicine
• Vocal Cord Contact Ulcers - The Merck Manuals Online Medical Library

References