Granuloma of the membranous vocal fold: an unusual complication of microlaryngoscopic surgery.
OBJECTIVE
We describe the clinical features of granuloma of the membranous vocal fold (as opposed to granuloma of the vocal process, or "contact granuloma"), a poorly recognized sequela of microlaryngoscopic surgery. Membranous vocal fold granuloma may mimic the initial lesion in appearance, and thus be mistaken for recurrence.


METHODS
We performed a retrospective review of cases from 2 institutions.


RESULTS
Fifteen cases of membranous vocal fold granuloma from 2 institutions were identified. In all but 1 case, granuloma developed in the early postoperative period, within 8 weeks. Of the 15 cases, 10 followed laser resection of carcinoma. Five were noted following cold steel resection of benign lesions (2 papillomas, 2 cysts, 1 Reinke's edema). Technical aspects of these cases suggest that membranous vocal fold granulomas result from surgical violation of deep tissue planes and/or epithelial defects. All patients were treated with proton pump inhibitors. In 12 cases, the granulomas proved self-limited, resolving over weeks to months following surgery. Three patients underwent surgical removal of the lesion, which confirmed the diagnosis. One of these cases recurred and was treated nonsurgically.


CONCLUSIONS
Granuloma should be suspected when a mass lesion appears at the surgical site early in the postoperative course. Surgical excision is generally not necessary and may provoke further growth of granulation tissue.
Sulica
Lucian
L
Department of Otorhinolaryngology, Weill Medical College of Cornell University, New York, New YOrk, USA.
Simpson
C Blake
CB
Branski
Ryan
R
McLaurin
Colby
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007818:Laryngeal Diseases / Q000209:etiology* / Q000628:therapy; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D014827:Vocal Cords
D054328:Proton Pump Inhibitors