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This study aims to show the response of contact granuloma (CG) to Botulinum toxin type A injection (BTXA), proton pump inhibitors (PPI) and voice therapy (VT). Materials and methods: A non-randomized prospective analytical study was done at a tertiary care hospital, in which 70 patients with CG were seen over a 2 years period. Depending on the size of the CG, the patients were divided into three groups and treated as below: Group A: VT + BTXA+ PPI for farewell grade I and II CG Group B: VT + BTXA + PPI + Microlaryngeal surgery (MLS) for Farewell Grade III and IV CG Group C: VT + PPI (a group which did not agree for BTXA). Statistical analysis: Data were analyzed and stored using Microsoft Excel 2010 file and qualitative data was represented in the form of frequency and percentage. Results: Of the 70 patients in our study, we included 30 patients in group A, 19 in group B and 21 included in group C. All Group A patients (100%) resolved; however 1 patient needed a reinjection of BTXA. In group B, 18 patients (94.7%) resolved,1 patient (5.3%) had recurrence. In Group C, 18 patients (85.7%) resolved, and three patients (14.3%) had persistent CG. Conclusion: In our study, patients of farewell grade I and II treated with BTXA, PPI and VT had a 100% resolution rate. Surgery along with BTXA, PPI and VT is an acceptable treatment modality for farewell grade III and IV CG, as our study indicated a 94.7% success rate and 5.3% recurrence rate. The patients who did not receive BTXA had a decreased rate of resolution (85.7%).

Multimodality Treatment for the Contact Granuloma of the Vocal Folds