CLINICAL CHARACTERISTICS, ENDOSCOPIC FINDINGS AND ASSOCIATED FACTORS OF POSTOPERATIVE RECURRENT VOCAL PROCESS GRANULOMA IN PATIENTS WITH LARYNGOPHARYNGEAL REFLUX
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Abstract
Objective: To describe the clinical characteristics, endoscopic findings, and associated factors of postoperative recurrent vocal process granuloma in patients with laryngopharyngeal reflux. Study and study methods: A prospective descriptive study was conducted on 19 patients diagnosed with postoperative recurrent vocal process granuloma associated with laryngopharyngeal reflux at the National Otorhinolaryngology Hospital from July 2024 to July 2025. Clinical characteristics, Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and endoscopic findings were collected and analyzed. Results and discussion: The mean age of the patients was 48.2 ± 12.4 years, and all were male. Most patients (52.6%) had undergone one prior surgery, while 10.6% had undergone three or more surgeries; 57.9% experienced recurrence within the first 3 months. The most common symptoms were hoarseness, throat clearing, foreign body sensation in the throat, and excessive throat mucus (100%). The mean RSI score was 19.37 ± 4.96, and the mean RFS score was 13.84 ± 2.14. Granulomas were predominantly unilateral (94.7%), with left-sided predominance (68.4%), and most lesions were classified as grade II or III. The most common endoscopic findings of laryngopharyngeal reflux included ventricular obliteration, erythema, vocal fold edema, laryngeal edema, and posterior commissure hypertrophy (100%). No significant association was found between granuloma grade and RSI, RFS scores, or the number of previous surgeries (p > 0.05). Conclusion: Postoperative recurrent vocal process granuloma associated with laryngopharyngeal reflux commonly occurs in middle-aged men, with a high rate of early recurrence. The condition presents with typical clinical and endoscopic features of laryngopharyngeal reflux; however, lesion severity does not appear to be significantly associated with reflux scores or the number of prior surgeries.
Keywords
Recurrent vocal process granuloma, postoperative, laryngopharyngeal reflux, RSI, RFS
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References
[2]. Hong-Gang D, He-Juan J, Chun-Quan Z, et al. Surgery and proton pump inhibitors for treatment of vocal process granulomas. Eur Arch Otorhinolaryngol 2013;270:2921–6. https://doi.org/10.1007/s00405-013-2527-8.
[3]. Rudman JR, McGee CS, Diaz J, et al. Assessing the utility of non-surgical treatments in the management of vocal process granulomas. J Laryngol Otol 2020;134:68–73. https://doi.org/10.1017/S0022215119002524.
[4]. Hoàng Thị Hoà Bình. Nghiên cứu hình thái lâm sàng của u hạt thanh quản qua nội soi và tìm hiểu các yếu tố nguy cơ. Luận văn thạc sĩ y học. Đại học Y Hà Nội, 2011.
[5]. Phạm Thanh Hương. Đánh giá kết quả điều trị nội khoa u hạt thanh quản tái phát sau phẫu thuật. Luận văn thạc sĩ y học. Đại học Y Hà Nội, 2015.
[6]. Wang C-P, Ko J-Y, Wang Y-H, et al. Vocal process granuloma – A result of long-term observation in 53 patients. Oral Oncology 2009;45:821–5. https://doi.org/10.1016/j.oraloncology.2009.01.008.
[7]. Jaroma M, Pakarinen L, Rouhiainen P, et al. How to Handle Vocal Cord Granuloma. Acta Oto-Laryngologica 1988. https://doi.org/10.3109/00016488809106363.
[8]. Nguyễn Thanh Bình. Nghiên cứu hình thái lâm sàng, mô bệnh học và kết quả điều trị u hạt thanh quản. Luận văn thạc sĩ y học. Đại học Y Hà Nội, 2012.
[9]. Hillel AT, Lin L-M, Samlan R, et al. Inhaled Triamcinolone with Proton Pump Inhibitor for Treatment of Vocal Process Granulomas: A Series of 67 Granulomas. Ann Otol Rhinol Laryngol 2010;119:325–30. https://doi.org/10.1177/000348941011900509.
[10]. Lee YS, Choi S-H, Son YI, et al. Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease. Eur Arch Otorhinolaryngol 2011;268:863–9. https://doi.org/10.1007/s00405-010-1475-9.