Revista de Otologia e Rinologia

Treatment of Recurrent Vocal Cord Granuloma with Percutaneous Steroid Injection

Kurt Nelson and John Schweinfurth

Treatment of Recurrent Vocal Cord Granuloma with Percutaneous Steroid Injection

Vocal cord granulomas are areas of chronic inflammation, usually located near the vocal process, caused by a variety of conditions such as intubation, gastroesophageal reflux disease, and vocal abuse. They are often difficult to eradicate. Treatments range from conservative management using anti-reflux medications, inhaled steroids, and voice therapy, to more invasive measures such as surgical excision, botulinum toxin injection, and steroid injection. Surgical treatment often leads to a high rate of recurrence. Botulinum toxin injections have shown promise in preliminary studies, but are not appropriate for all patients due to potential adverse effects. Percutaneous steroid injection offers a safe, minimally invasive, yet effective method of treating and preventing recurrence of both primary and recurrent vocal cord granulomas.

This paper reports successful treatment of a recurrent vocal cord granuloma using percutaneous steroid injection in a patient who failed both medical management and multiple surgical excisions. Complete resolution was seen two months after the second steroid injection. The patient has remained disease free one year from the final treatment, maintained only on daily proton pump inhibitor therapy. This case demonstrates there are multiple options available to treat this disease, and more prospective research is needed to establish a consistent treatment algorithm for all subsets of patients.