A Case of Laryngeal Granulomas After Oral and Maxillofacial Surgery With Prolonged Intubation

Laryngeal granuloma development can be a postoperative complication of laryngeal trauma or irritation resulting from general anesthesia and endotracheal intubation. These rare benign lesions are located primarily over the cartilaginous portions of the larynx, particularly the vocal processes of the arytenoids. Airway manipulation during the intubation process and prolonged intubation periods can be contributing factors to intubation-related laryngeal granulomas, which may manifest 1 to 4 months after intubation. The patient in this case was a female who returned with complaints of throat pain without hoarseness or sensations of a “lump in her throat” 3 months following surgery, during which she was intubated with a 7.0-mm nasotracheal tube for 30 hours, likely contributing to her bilateral laryngeal granulomas. The patient underwent successful conservative medical management consisting of a proton pump inhibitor and an inhaled corticosteroid.

Diagnosis of anxiety-depression disorders in patients with laryngeal granuloma

Objectives - to determine the variants of psychiatric disorders in patients with laryngeal granuloma using the affectivity-stress model, based on the complex psychopathological and clinical-psychological diagnostics of anxiety-depression disorders (ADD). Material and methods. We examined 80 patients, aged from 33 to 65 years. Postintubation granuloma was diagnosed in 7 patients. GERD was diagnosed in 56 patients. 49 patients had a relapse granulomas after surgery. Results and Conclusion. The correlation of laryngeal granuloma with the disorders of the anxiety-depression spectrum (ADD) was established. In most patients, the development of granuloma occurred with underlying psychiatric disorder. The role of anxiety in the structure of ADDs and the significance of their diagnosis for the choice of therapeutic tactics is proved. It is necessary to examine the patients with laryngeal granuloma for the presence of ADDs, and to consult a psychiatrist to determine an individual therapeutic tactics.

Evaluation of narrow band imaging in the assessment of laryngeal granuloma

Laryngeal granulomas belong to common complications following trans-oral laser microsurgery (TLM). The aim of this study was to evaluate NBI in the differentiation between granuloma-like lesions and local tumor recurrence. 154 consecutive patients after TLM due to early laryngeal cancer were enrolled. In the group, a monthly follow-up including NBI endoscopy was performed. Moderate and severe dysplasia, carcinoma in situ and invasive cancer were defined as positive histology, laryngeal granuloma and other benign laryngeal lesions as negative histology and premalignant lesions as suspicious histology. In 47/154 (31%) cases, granuloma-like lesion (GLL) was found. Patients with GLL were divided into two groups based on the NBI classification. In all patients, the microvascular pattern in NBI was compared with the final histology. In group A, with suspicious, perpendicular vessels, 13/13 (100%) samples were positive. In group B, with normal vascular pattern 3/34 (9%) samples were positive and 31/34 (91%) samples were negative. There was a significant correlation between the positive NBI vascular pattern and the final histology (p = 0.00001). Sensitivity, specificity, accuracy of NBI were as follows: 81%, 100%, 94%, respectively.Based on our results, NBI can reliably differentiate between postoperative laryngeal granuloma and local tumor recurrence. In such a manner, this method is very helpful in the follow-up of tumor patients.