Vocal Therapy in Lieu of Surgery for Contact Granuloma: A Case Report

Abstract

A case in which resolution of a contact granuloma of the larynx is attained with a regimen of vocal therapy and psychological support and in which regression of the granuloma is demonstrated objectively by comparison of pre- and posttherapeutic laryngoscopic and vocal-aerodynamic parameters is presented. It is concluded that surgery should probably never be used as initial therapy for contact granuloma of the larynx, regardless of its presumed state of evolution; instead, a course of intensive vocal therapy should be tried. A corollary to this conclusion is that competent vocal therapy has a considerable psychological content, since its basic aim is to alter the patient’s image of what an efficient voice should be. It is also concluded that pre- and posttherapeutic objective quantification of the granuloma and of the several aerodynamic parameters in phonation can furnish not only a reliable guide to therapy, but also a powerful argument in favor of vocal therapy in these cases.