title: Analysis of therapeutic methods for treating vocal process granulomas.
abstract: CONCLUSIONS
  The combination of laryngeal microsurgery and local injections of botulinum toxin type A (BTA) can increase the cure rate of patients with vocal process granulomas (VPGs).
  
  
  OBJECTIVE
  To analyze the therapeutic effects of conservative treatments, microsurgical resection with suturing and microsurgery in combination with local injections of BTA for the treatment of VPGs.
  
  
  METHODS
  A retrospective analysis of 168 cases of VPG was performed. All of the patients initially received a conservative treatment. Some of the patients who did not respond to the conservative treatments were treated using microsurgical resection and microsuturing using an 8-0 absorbable filament. Other patients additionally received a four-point injection of BTA into the thyroarytenoid muscle and the arytenoid muscle on the operated side.
  
  
  RESULTS
  The lesions of 41.3% (71/168) of the patients who were given the conservative treatments (including acid suppression, vocal rest, and voice therapy) disappeared, and the lesions of 10.7% (18/168) of the patients were reduced. The conservative treatments were unsuccessful for 47% (79/168) of the patients. The cure rate was 78.4% (29/37) for the patients who were treated by microscope resection using a CO2 laser and microsuturing of the surrounding mucosa. Of the eight patients who experienced a recurrence, five of them had lesions that disappeared after 3 months of conservative treatment, whereas the other three patients recovered after a second operation. The cure rate of the 42 patients who were treated using microsurgery combined with local injections of BTA was 95.2% (40/42), with only 2 cases of recurrence at 2 months post-treatment.
authors: Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education of China), Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University , Beijing , China.
authors: Lijing
authors: L
authors: Ma
authors: Yang
authors: Y
authors: Xiao
authors: Jingying
authors: J
authors: Ye
authors: Qingwen
authors: Q
authors: Yang
authors: Jun
authors: J
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D064098:Esomeprazole / Q000627:therapeutic use; D005260:Female; D006099:Granuloma / Q000628:therapy*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000628:therapy*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D054328:Proton Pump Inhibitors; D019274:Botulinum Toxins, Type A; D064098:Esomeprazole
keywords: Microsurgery; botulinum toxin type A; conservative treatment; microsuturing