TREATMENT VOCAL FOLD GRANULOMA USING BOTULINUM TOXIN TYPE-A

Contact granuloma of the vocal folds has been associated with abnormal use of the voice, and acid reflux may exacerbate the inflammatory pro cess. Treatments have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medi cal management. Localized injections of botulinum toxin type A (BOTOX( R)) have been effective in patients with disorders of muscular control in the head and neck. fn this study, granulomas resolved in six patie nts who underwent injection of the affected vocal folds. Botulinum tox in type A is probably successful because it prevents forceful closure of the arytenoids during phonation and coughing. Localized injection o f this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard thera py or who are poor surgical candidates.