title: [Diagnosis and treatment of vocal process granuloma induced by gastroesophageal reflux: four cases report].
abstract: OBJECTIVE
  To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux.
  
  
  METHODS
  We performed a retrospective review of 4 cases.
  
  
  RESULTS
  In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence.
  
  
  CONCLUSIONS
  Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
authors.forename: Zhaosheng
authors.initials: Z
authors.lastname: Li
authors.forename: Haibo
authors.initials: H
authors.lastname: Xu
authors.forename: Yanli
authors.initials: Y
authors.lastname: Hong
authors.forename: Weilin
authors.initials: W
authors.lastname: Shen
authors.forename: Lijuan
authors.initials: L
authors.lastname: Chen
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D001193:Arytenoid Cartilage / Q000473:pathology*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006099:Granuloma / Q000209:etiology*; D006801:Humans; D008297:Male; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole