Vocal process granuloma

Background. This review article reports the evolution of knowledge regardin g the benign proliferations of the posterior glottis commonly termed "vocal process granuloma". Methods. A comprehensive review of publications addressing lesions of the p osterior glottis is affected to analyze the contemporary management of voca l process granuloma. Results. Contemporary management emphasizes interventions to decrease irrit ation to the posterior glottis. Multiple causes of this irritation preclude use of a single management plan that will successfully address all cases. Conclusions. Management to diminish laryngopharyngeal reflux, as well as to correct vocally abusive behavior, will appropriately address the majority of vocal process granuloma. Surgical removal is best reserved for cases whe n conservative management fails, when airway obstruction is a concern, or w hen a biopsy is needed to establish the diagnosis. Ancillary measures that may be beneficial in specific cases include the use of steroids, antibiotic s, membranous vocal fold augmentation, and laryngeal botulinum neurotoxin i njection. (C) 2001 John Wiley & Sons, Inc.