Skip to main content Accessibility help

Interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma

  • A-L Hamdan (a1), E Khalifee (a1), H Jaffal (a1) and A Ghanem (a1)



To report on the efficacy and adverse effects of interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma.


A retrospective chart review was conducted of eight patients with vocal process granuloma resistant to anti-reflux therapy who underwent interarytenoid botulinum toxin A injection. The mean dosage of botulinum toxin A injected was 6.56 U.


Fifty per cent of patients had complete regression of the lesion and 50 per cent had partial regression. The main side effects were breathiness (n = 4), voice breaks (n = 1) and aspiration (n = 1).


Interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma is an effective mode of therapy, with transient vocal and swallowing side effects.


Corresponding author

Author for correspondence: Dr Abdul-Latif Hamdan, Department of Otolaryngology Head and Neck Surgery, American University of Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon E-mail: Fax: +961 1 350 000


Hide All

Dr A-L Hamdan takes responsibility for the integrity of the content of the paper



Hide All
1Ylitalo, R, Lindestad, PA. Laryngeal findings in patients with contact granuloma: a long-term follow-up study. Acta Otolaryngol 2000;120:655–9
2Farwell, D, Belafsky, P, Rees, C. An endoscopic grading system for vocal process granuloma. J Laryngol Otol 2008;122:1092–5
3Altman, KW. Vocal fold masses. Otolaryngol Clin North Am 2007;40:1091–108
4Havas, TE, Priestley, J, Lowinger, DS. A management strategy for vocal process granulomas. Laryngoscope 1999;109:301–6
5Emami, AJ, Morrison, M, Rammage, L, Bosch, D. Treatment of laryngeal contact ulcers and granulomas: a 12-year retrospective analysis. J Voice 1999;13:612–17
6Lee, SW, Hong, HJ, Choi, SH, Sun, DI, Park, YH, Lee, BJ et al. Comparison of treatment modalities for contact granuloma: a nationwide multicenter study. Laryngoscope 2014;124:1187–91
7Karkos, PD, George, M, Van Der Veen, J, Atkinson, H, Dwivedi, RC, Kim, D et al. Vocal process granulomas: a systematic review of treatment. Ann Otol Rhinol Laryngol 2014;123:314–20
8Hoffman, HT, Overholt, E, Karnell, M, McCulloch, TM. Vocal process granuloma. Head Neck 2001;23:1061–74
9Carroll, TL, Rosen, CA. Trial vocal fold injection. J Voice 2010;24:494–8
10de Lima Pontes, PA, De Biase, NG, Gadelha, ME. Clinical evolution of laryngeal granulomas: treatment and prognosis. Laryngoscope 1999;109:289–94
11Hillel, AD, Maronian, NC, Robinson, L, Waugh, PF, Klotz, DA. Treatment of the interarytenoid muscle with botulinum toxin for laryngeal dystonia. Ann Otol Rhinol Laryngol 2004;113:341–8
12Nasri, S, Sercarz, JA, McAlpin, T, Berke, GS. Treatment of vocal fold granuloma using botulinum toxin type A. Laryngoscope 1995;105:585–8
13Orloff, LA, Goldman, SN. Vocal fold granuloma: successful treatment with botulinum toxin. Otolaryngol Head Neck Surg 1999;121:410–13
14Pham, J, Yin, S, Morgan, M, Stucker, F, Nathan, CA. Botulinum toxin: helpful adjunct to early resolution of laryngeal granulomas. J Laryngol Otol 2004;118:781–5
15Damrose, EJ, Damrose, JF. Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma. J Laryngol Otol 2008;122:824–8
16Yılmaz, T, Kayahan, B, Günaydın, , Kuşçu, O, Sözen, T. Botulinum toxin A for treatment of contact granuloma. J Voice 2016;30:741–3
17Pham, Q, Campbell, R, Mattioni, J, Sataloff, R. Botulinum toxin injections into the lateral cricoarytenoid muscles for vocal process granuloma. J Voice 2018;32:363–6
18Fink, DS, Achkar, J, Franco, RA, Song, PC. Interarytenoid botulinum toxin injection for recalcitrant vocal process granuloma. Laryngoscope 2013;123:3084–7


Interarytenoid botulinum toxin A injection for the treatment of vocal process granuloma

  • A-L Hamdan (a1), E Khalifee (a1), H Jaffal (a1) and A Ghanem (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed