INTRODUCTION
LCG, is a kind of benign lesion that occurs around the vocal fold mucosa
and presents ulcer and granulation tissue hyperplasia, which is easy to
relapse and difficult to cure radically. After standardized treatment
for more than 3 months, those who still have no improvement or disease
recurrence are called refractory contact granuloma1.
LCG usually associated with several etiological factors such as
laryngopharyngeal reflux, habitual throat clearing and improper use of
voice. Thought the disease is not completely clear, it is usually
considered that mucosal inflammation and ulceration that occur the
posteromedial aspect of the vocal cords followed by granulation tissue
hyperplasia2.Intubation granuloma is self-limited,
caused by endotracheal intubation, and totally different from laryngeal
contact granuloma. Very few of the intubation granuloma could not heal
spontaneously, and surgery may resolve it well with low recurrence rate.
Conservative treatment and surgical treatment have been widely used in
contact granuloma, but almost both treatments cannot form consensus to
overcome the persistence and recurrence contact granuloma. Granulomas
cause psychological trauma and anxiety in patients, leading to loss of
interest in peripheral events3.In this article
advanced surgical methods with mucosal-flap and botulinum toxin A
injection are applied in the treatment of refractory
LCG, with significant efficacy and
extremely low recurrence rate.