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Contact ulcer/granuloma: Treatment, symptoms, advice and help

About contact ulcer/granuloma

Contact ulcer also called granuloma is a disorder of the vocal cords which is part of the larynx (voice box). The vocal cords are made up of cartilages and muscles and are responsible for voice production. Contact ulcer is an ulcerative lesion of the vocal cords which may occur as a result of excessive friction between the cartilages of the vocal cords.

Contact ulcer/granuloma: Incidence, age and sex

Contact ulcer is an infrequent disorder of the vocal cords which usually affects individuals in occupations which warrant excessive use of voice. Teachers, singers, tele-callers and lawyers are especially at risk for developing this contact ulcer.

Signs and symptoms of contact ulcer/granuloma: Diagnosis

The individual with contact ulcer may exhibit mild symptoms like sore throat and mild throat pain on speaking and swallowing. Hoarseness of the voice is another prominent symptom which may signify a defect in vocal cords. Some individuals may also experience tiredness of voice. The specialist may examine the throat to establish the diagnosis. Sometimes biopsy of the vocal cord tissue may be needed to rule out malignant lesion of vocal cords.

Causes and prevention of contact ulcer/granuloma

Contact ulcer results from too much rubbing of the vocal cord cartilages which may occur due to over use or misuse of voice. Over use of the voice may be encountered in certain occupations like singing, teaching or in sales. Some individuals misuse their voice by speaking in harsh or low pitch tone which may cause damage to the vocal cords. Moreover reflux of gastric acid into the throat as seen in gastro-oesophageal reflux disease (GERD) may also predispose to contact ulcer.

Contact ulcer/granuloma: Complications

Usually contact ulcer does not result in any structural or functional complications. However ulcer of the vocal cord may get complicated by bacterial infections wherein the affected individual may experience fever and intense throat pain.

Contact ulcer/granuloma: Treatment

The treatment of contact ulcer is generally conservative. Adequate rest to voice for about 1 month is mandatory without which, recovery is extremely difficult. Consultation with a speech therapist may be helpful in some individuals who misuse their voice. The speech therapist may help such individuals by teaching them proper use of voice and thereby prevent further similar episodes. Medication like antibiotics may be prescribed in cases of bacterial infection of the ulcerative lesion. Individuals with GERD may need antacids to prevent reflux of gastric acid into throat. Surgical resection of ulcer is usually not needed in affected individuals until and unless the ulcer is big in size and does not heal after conservative measures.