A granuloma, also called a contact ulcer, is a benign (non-cancerous) area of inflammation typically located on the back of the larynx. Contact granulomas may occur bilaterally (both vocal folds) or unilaterally (one vocal fold).

Symptoms of a Granuloma

Unless the area of inflammation is large, the presence of a granuloma often does not affect the vibration of the vocal folds or impact the voice. However, many patients complain of:

  • Throat pain
  • Throat irritation
  • Lump in the throat sensation
  • Vocal fatigue

Causes of a Granuloma

Contact ulcers could have many causes, including the following:

  • Laryngeal intubation injury after surgery or long-term airway ventilation
  • Esophageal reflux, which could irritate the back of the larynx and put this area at higher risk of ulceration
  • Vocal misuse/abuse, especially the use of a pressed, loud, low-pitched voice quality

Diagnosing a Granuloma

A contact ulcer can be diagnosed with a test called a laryngoscopy. There are two ways of performing this procedure: For indirect laryngoscopy, a small, long-handled mirror is inserted into the throat to see parts of the larynx. For direct laryngoscopy, an instrument called a laryngoscope (a narrow, lighted tube) is inserted through the nose or mouth to get a better view than the indirect laryngoscopy.

Treatments for Granuloma

In order to treat granuloma, your doctor may discuss several options, including the following:

  • Medication to manage reflux
  • Minimizing throat clearing and coughing to decrease irritation
  • Voice therapy to improve vocal patterns in order to decrease pressure on the back of the larynx

Granulomas may take many months or even up to a year or two to heal.

Surgery is typically not recommended because the lesions usually return after surgery (often larger). However, if medication and voice therapy techniques do not help or if the lesions are impacting quality of life, your doctor may consider additional treatments, including steroids or an in-office surgical procedure.

Why Choose Columbia

Columbia delivers advanced, personalized care to each of our patients. Our team conducts state-of-the-art clinical and scientific research with the goal of transforming our ability to treat even the most serious voice and swallowing disorders. Some patients may never require surgery or a procedure, but many need voice and swallowing rehabilitation. Specialized exercises and lifestyle modifications can give you back the ability to speak, sing, and enjoy a meal with loved ones.