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Surgical Treatment of Recurrent Vocal Process Granuloma using Carbon-dioxide Laser and Mitomycin-C

Surgical Treatment of Recurrent Vocal Process Granuloma using Carbon-dioxide Laser and Mitomycin-C

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Various treatment modalities for vocal process granuloma include simple observation, antireflux therapy, voice therapy, botulinum injection, and steroid inhalation, but recurrence rates are high. Surgical excision can be considered in refractory and recurrent cases. In this study, the authors report the effectiveness of surgical excision using a carbon-dioxide laser with topical Mitomycin-C for the treatment of recurrent vocal process granuloma. The study included 28 patients with recurrent vocal process granuloma despite various treatments. The vocal process granuloma was excised using a carbon-dioxide laser and 1 cc of 0.4 mg/mL topical Mitomycin-C was applied for 4 minutes. Follow-up duration was 13-33 months (mean, 21.8 months). Of 28 patients, 19 (67.9%) were cured. Two who received surgical excision as a first-line treatment, 2 who used a steroid inhaler as a first-line treatment, and 5 who previously took antireflux medication as initial treatment showed recurrence. Surgical excision using a carbon-dioxide laser with topical application of Mitomycin-C is considered effective for recurrent vocal process granuloma.

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