Application of local flipped pedicle microflap combined with botulinum
toxin A injection in the treatment of refractory laryngeal contact
granuloma
Abstract
Objective Laryngeal contact granuloma (LCG) is a kind of benign lesion
that related with improper use of voice, habitual throat clearing and
laryngopharyngeal reflux. Under 3 months standardized treatment, those
who have no improvement or disease recurrence are called refractory LCG.
The purpose of this study was to explore an advanced surgical method
with local flipped pedicle microflap combined with botulinum toxin A
injection in the treatment of refractory LCG. Design A retrospectively
analysed of totally 11 patients with refractory LCG from January 2018 to
December 2020. After CO2 laser granuloma resection with local flipped
pedicle microflap combined with botulinum toxin A injection, the
patients were followed up at 1, 3, 6 and 12 months after operation to
evaluate the effect of the surgery. Descriptive statistical methods were
used to analyze and summarize the improvement of postoperative symptoms
and signs of laryngoscope. Results During follow-up, 4 of 11 patients
had residual pseudomembrane under the electronic laryngoscope, and had
smooth mucosa when subsequent follow-up. The remaining 7 cases of
electronic laryngoscope granuloma disappeared. Up to now their symptoms
disappeared, and there were no systemic and local complications.
Conclusion CO2 laser granuloma resection with local flipped pedicle
microflap combined with botulinum toxin A injection can achieve the
lesion clearance, restore the integrity of vocal fold cover-body,
preserve the perichondrium, and reserve a time window for microflap
recovery. It is based on the principle of preserving normal mucosa, with
high cure rate and no recurrence. It is worthy of clinical promotion.