Laryngopharyngeal reflux disease management for recurrent laryngeal contact granuloma: A case report

Figure 1 Laryngeal contact granuloma before the first operation. A: A laryngeal contact granuloma (LCG) initially presented with a lesion on the left vocal process; B: The LCG was removed in the first operation; C: The first pathological result: (left vocal cord mass) mucosal ulcer with inflammatory granulation tissue polypoid hyperplasia.

Figure 2 Relapse-reoperation-recurrence. A: Two months after granuloma excision, re-examination by laryngoscopy revealed that the left vocal cord granuloma had recurred; B: Three months after granuloma excision, re-examination by laryngoscopy revealed that the left vocal cord granuloma had recurred; C: After the second surgical intervention, the laryngeal contact granuloma (LCG) was again removed; D: The second pathological result was consistent with the first result; E: Three months after the second surgery the LCG recurred at the edge of previous lesion under a treatment regimen of rabeprazole enteric-coated capsules (20 mg bid) combined with mosapride tablets (5 mg tid) for 8 wk; F: A laryngoscopic review revealed no change in LCG size following 12 wk of ilaprazole enteric-coated capsules (10 mg qd) and mosapride tablets (5 mg tid) administration.

Figure 3 Disappearance and no recurrence. A: The size of the laryngeal contact granuloma (LCG) was reduced at three months after initiating a new anti-reflux regimen consisting of a combination of ilaprazole enteric-coated capsules (10 mg qd), mosapride tablets (5 mg tid) and compound digestive enzyme capsules (2 tablets); B: LCG was undetectable six months after starting the cocktail therapy; C: No recurrence of the granuloma was observed six months after the patient discontinued medications; D: No recurrence of the granuloma after the patient had discontinued therapy for 1 year.