ABSTRACT
Objective Laryngeal contact granuloma (LCG) is a kind of benign
lesion that related with improper use of voice, habitual throat clearing
and laryngopharyngeal reflux. Under 3 months standardized treatment,
those who have no improvement or disease recurrence are called
refractory LCG. The purpose of this study was to explore an
advanced surgical method with
local flipped pedicle microflap
combined with botulinum toxin A injection in the treatment of refractory
LCG. Design A retrospectively analysed of totally 11 patients
with refractory LCG from January 2018 to December 2020. After
CO2 laser granuloma resection with local flipped pedicle
microflap combined with botulinum toxin A injection, the patients were
followed up at 1, 3, 6 and 12 months after operation to evaluate the
effect of the surgery. Descriptive statistical methods were used to
analyze and summarize the improvement of postoperative symptoms and
signs of laryngoscope. Results During follow-up, 4 of 11
patients had residual pseudomembrane under the electronic laryngoscope,
and had smooth mucosa when subsequent follow-up. The remaining 7 cases
of electronic laryngoscope granuloma disappeared. Up to now their
symptoms disappeared, and there were no systemic and local
complications. Conclusion CO2 laser granuloma
resection with local flipped pedicle microflap combined with botulinum
toxin A injection can achieve the lesion clearance, restore the
integrity of vocal fold cover-body, preserve the perichondrium, and
reserve a time window for microflap recovery. It is based on the
principle of preserving normal mucosa, with high cure rate and no
recurrence. It is worthy of clinical promotion.