Thyroarytenoid botulinum toxin injection for refractory laryngeal contact granuloma

Background: Although there are many treatments for laryngeal contact granuloma (LCG), some patients still fail treatment. Botulinum toxin A injection vocal cords may be a salvage therapy. Objectives: To study the efficacy of thyroarytenoid botulinum toxin A injection for the treatment of refractory LCG. Material and methods: From May 2021 to March 2022, 23 male patients with refractory idiopathic LCG were treated by injection of botulinum toxin A into the thymarytenoid muscle via the thyrohyoid membrane approach. Inspiratory-phase laryngoscopy images were collected before treatment and 3 months after injection treatment. The lesion size was evaluated with the Farwell granuloma endoscopic grading system and Image J software. Results: The average age of 23 patients was 49 years. The dose of botulinum toxin injection ranged from 2.5 to 5 units. Three months after injection, 17 patients were cured, 2 patients showed marked improvement, and 4 patients did not experience any effect. The total efficacy rate was 82.61% (19/23), and no serious complications occurred. Almost all patients experienced hoarseness within one week after injection; they gradually recovered after one month, and their voice returned to baseline at 3 months. Conclusions: Thymarytenoid botulinum toxin injection is an effective method for resolving refractory LCG.

Automated summary

Injecting botulinum toxin A into the thyroarytenoid muscle via the thyrohyoid membrane approach is an effective method for treating refractory laryngeal contact granuloma, with a total efficacy rate of 82.61%, and no serious complications occurred.