Complications related to tracheal intuation are many, but intubation granuloma is a rare complication. The authors experienced a case of recurrent intubation granulomas in spite of removal of granuloma with CO2 LASER under suspension laryngosoopy. We used neuroleptic analgesia for the third operation in order to avoid tracheal intubation. The result was excellent after the third operation, and there was no recurrence noted for 8 months.
Analgesia ; Anesthesia* ; Granuloma ; Granuloma, Laryngeal* ; Intubation ; Lasers, Gas ; Recurrence

Intubation granuloma is a delayed complication of endotracheal intubation in adults.The most frequent complaint of the patient with laryngeal granuloma is hoarseness and the most common location of the granuloma is the vocal process of arytenoid cartilage.We report a female patient with incidentally detected granuloma during endotracheal intubation who had no preoperative vocal symptoms.
Female ; Granuloma ; Granuloma, Laryngeal ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal

Laryngeal granulomas which grow in the rear of the vocal cords can be a refractory and recurrent condition, because of various pathogeneses and a lack of established treatment guidelines. We experienced a laryngeal granuloma case which recurred repeatedly, and was resistant to modern medicinal treatment. The laryngeal granuloma recurred after microlaryngosurgery. And though a second microlaryngosurgery and laser cauterization was done, followed by prescription of lansoprazole, tranilast, chlarithromycin and inhalation of fluticasone propionate, the laryngeal granuloma recurred once more. Thus, we tried Kampo medicines at the this time. Hangekobokuto, saishakurikkunshito and keikyososooushimbuto were stopped due to lack of efficacy on the ganuloma, and the Kampo formulation was changed to kairosan. Three weeks after changing formulation, the granuloma was no longer seen with laryngeal fiberscopy. And to-date, recurrence of the granuloma has not been confirmed. This case suggests that fatigue, body weight loss, bilateral Kyokyo-kuman (discomfort of the hypochondrium), bilateral excessive strain of abdominal muscles, pulsation of both the upper and lower navel, and tympanitic sound in upper abdomen may be clinical indications for kairosan.
Granuloma ; recur ; Red color ; Granuloma, Laryngeal ; Medicine, Kampo

The authors have been experienced a case of laryngeal granuloma following endotracheal anesthesia which is rare in children and have used two different method of general anesthesia for resection of granuloma. These two methods are; 1) using endotracheal tube insertion for general anesthesia. 2) applying general anesthesia via under mask. Comparing with two different methods of general anesthesia, we come to the conclusion that the former is more reliable for clinical anesthesia because of supplying continuous positive pressure with oxygen and anesthetics in spite of poor operation field.
Anesthesia ; Anesthesia, Endotracheal ; Anesthesia, General* ; Anesthetics ; Child ; Granuloma* ; Granuloma, Laryngeal* ; Humans ; Masks ; Methods ; Oxygen

BACKGROUND AND OBJECTIVES: Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. MATERIALS AND METHOD: Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. RESULTS: Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. CONCLUSION: Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.
Granuloma ; Granuloma, Laryngeal ; Humans ; Intubation ; Intubation, Intratracheal ; Larynx ; Methods ; Microsurgery ; Nasal Cavity ; Risk Factors ; Voice

The laryngeal granuloma (LG) is non-neoplastic lesion that mainly develops in the posterior vocal folds. It is welknown that mis- or overuse of voice, habitual coughing, and endotracheal intubation can become the cause of LG. The laryngopharyngeal reflux also comes into the spotlight as an etiologic factor. Although LG has a tendency to recur easily, it is not a premalignant lesion. The co-existence with granuloma and laryngeal cancer has not been reported earlier. Recently, we encountered a 72-year-old man with a posterior glottic mass, which was diagnosed as squamous cell carcinoma coexisting with granuloma. To our knowledge, this is a first report on two coexisting carcinomas in the glottis.
Aged ; Carcinoma, Squamous Cell* ; Cough ; Glottis* ; Granuloma* ; Granuloma, Laryngeal ; Humans ; Intubation, Intratracheal ; Laryngeal Neoplasms ; Laryngopharyngeal Reflux ; Neoplasms, Squamous Cell ; Vocal Cords ; Voice

BACKGROUND AND OBJECTIVES: Mitomycin-C is an antibiotic, antineoplastic agent that inhibits DNA and protein synthesis, and fibroblast proliferation. It has been successfully used in adjunction to glaucoma surgery, dacryocystorhinostomy, pterygium surgery, and middle meatal antrostomy. The purpose of this study is to evaluate the efficacy and safety of intraoperative Mitomycin-C application as an adjunct therapy in the endoscopic treatment of laryngeal stenosis and granulation. MATERIALS AND METHOD: A total 13 subjects, of whom 2 had anterior glottic web, 4 posterior laryngeal stenosis, and 7 laryngeal granuloma were included. All underwent stroboscopy and were treated with endoscopic laryngomicrosurgery with CO2 laser. Then, 1 cc of 0.4 mg/mL Mitomycin-C was directly applied for 4 minutes on the surgical site. The patients' symptoms were assessed, and the size of the airway was graded on a scale of I (< or =50%) to IV (total occlusion) after a mean follow-up period of 5 months. The recurrence of the laryngeal granuloma was checked. RESULTS: There was a significant improvement in postoperative symptoms in the group of posterior laryngeal stenosis. Two with tracheotomy underwent decannulation. The postoperative size of airway was markedly increased and restenosis was not noted. There was only one case of recurrence in the granuloma group. CONCLUSION: According to these preliminary results, it is suggested that application of Mitomycin-C can be used as a beneficial adjunct therapy in the endoscopic COc laser excision for laryngeal stenosis and granuloma.
Dacryocystorhinostomy ; DNA ; Fibroblasts ; Follow-Up Studies ; Glaucoma ; Granuloma* ; Granuloma, Laryngeal ; Laryngostenosis* ; Lasers, Gas ; Mitomycin* ; Pterygium ; Recurrence ; Stroboscopy ; Tracheotomy

Adult ; Aged ; Aged, 80 and over ; Granuloma ; drug therapy ; Humans ; Laryngeal Diseases ; drug therapy ; Male ; Middle Aged

Carcinoma ; diagnosis ; Granuloma, Plasma Cell ; diagnosis ; Humans ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology

Adult ; Aged ; Female ; Granuloma, Laryngeal ; etiology ; Humans ; Intubation, Intratracheal ; adverse effects ; Male