Laryngeal Granulomas; Characteristics and Our Clinical Approach Laringeal Granulomalar; Karakteristik Özellikleri ve Klinik Yaklaşımımız

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Altan E., Söylemez D., BARMAK E.

Anatolian Journal of General Medical Research, cilt.35, sa.3, ss.276-281, 2025 (Scopus, TRDizin)

Özet

Objective: This study aims to present our clinical approach and treatment strategies for laryngeal granulomas, emphasizing etiological differentiation and individualized management. Methods: This retrospective study included 65 patients diagnosed with laryngeal granulomas over a 3-year period. Patients were categorized into two main etiological groups: contact granulomas and intubation-induced granulomas. Clinical evaluations involved videolaryngostroboscopy, symptom assessment, and voice analysis when available. Treatment was tailored to etiology and included medical reflux management, voice therapy, surgical excision, and botulinum toxin injection in selected cases. Results: Contact granulomas accounted for 90.8% of cases and were more prevalent in males. Laryngopharyngeal reflux emerged as the most common underlying factor in both subgroups. All patients received standardized anti-reflux therapy, which significantly reduced recurrence rates. In patients with persistent or bilateral lesions, botulinum toxin injection proved to be a valuable adjunctive treatment. Surgical excision was reserved for lesions causing airway compromise or not responding to conservative treatment, and was always combined with medical management to reduce recurrence risk. Among the 12 patients who underwent surgery, recurrence was more common in those who had excision alone than in those who also received botulinum toxin. Conclusion: Our findings highlight the importance of identifying the underlying etiology in managing laryngeal granulomas. A multimodal, etiology-driven treatment strategy-particularly emphasizing reflux control-offers favorable outcomes. Botulinum toxin injection appears to enhance treatment success in refractory or recurrent cases and should be considered as part of individualized management protocols.