A granuloma is an inflammatory mass that grows in the larynx, usually in the back. It results from exposed cartilage due to vocal trauma. Acid reflux causes inflammation at the site of the exposed cartilage and results in the formation of a large mass.
The symptoms vary according to the size of the granuloma and the voice demands of the patient. They may range from being totally asymptomatic to severe breathiness, or hoarseness. Patients also report a foreign body sensation (the sensation of something being stuck in their throat). Rarely there is pain associated with granulomas.
A granuloma forms where there is exposed cartilage; the cartilage of the vocal folds is located in the back of the larynx. A granuloma will appear as a large, one-sided mass that blocks a part of the airway.
The most effective treatment is aggressive management of reflux. Acid reflux creates an environment in which granulomas form and grow. Aggressive control with diet and medication can reduce the granuloma significantly and often results in total resolution. Surgery usually fails for granulomas, with rapid recurrence afterwards.