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Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma

  • E J Damrose (a1) and J F Damrose (a2)
  • DOI:
  • Published online: 01 October 2007

This study evaluated the role of botulinum toxin type A in the treatment of refractory laryngeal granulomas.

Study design and setting:

Retrospective clinical review at a tertiary care hospital. Seven patients with vocal process granulomas underwent percutaneous injection of botulinum toxin into both vocal folds, performed in an office setting. Total doses ranged from 10 to 25 U, divided between both vocal folds.


All patients experienced resolution of their granulomas over two to seven weeks. No patient developed aspiration pneumonia. All patients experienced hoarseness secondary to the injections, but voice quality returned to baseline in all patients as the toxin was degraded.


Botulinum toxin is safe and effective therapy in resolving vocal process granulomas in patients refractory to traditional therapy. The optimal treatment dose remains to be determined.


Percutaneous botulinum toxin injection is helpful in resolving laryngeal granulomas.

Corresponding author
Address for correspondence: Dr Edward J Damrose, Department of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, 801 Welch Road, Stanford, CA 94305, USA. Fax: 650 725 8502 E-mail:
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Presented in part as a poster at the American Bronchoesophagological Association Annual Meeting, 14 May 2005, Boca Raton, Florida, USA.

Linked references
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1TE Havas , J Priestley , DS Lowinger . A management strategy for vocal process granulomas. Laryngoscope 1999;109:301–6

2PA de Lima Pontes , NG De Biase , MEC Gadelha . Clinical evolution of laryngeal granulomas: treatment and prognosis. Laryngoscope 1999;109:289–94

3C Jackson , CL Jackson . Contact ulcer of the larynx. Arch Otolaryngol 1935;22:115

4S Nasri , JA Sercarz , T McAlpin , GS Berke . Treatment of vocal fold granuloma using botulinum toxin type A. Laryngoscope 1995;105:585–8

5LA Orloff , SN Goldman . Vocal fold granulomas: successful treatment with botulinum toxin. Otolaryngol Head Neck Surg 1999;121:410–13

7L Sulica , D Blitzer . Operative Techniques in Otolaryngology/Head and Neck Surgery; Botulinum Toxin in the Treatment of Spasmodic Dysphonia. New York: Elsevier, 2004;76–9

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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