Clinical outcomes of high-frequency electrocautery surgery and proton pump inhibitor therapy for refractory laryngeal contact granuloma

TL;DR

A combination of electrocautery surgery and acid-suppressing drugs effectively treats a hard-to-manage voice disorder with minimal side effects and no need for general anesthesia.

Contribution

A new effective and minimally invasive treatment for refractory laryngeal contact granuloma combining electrocautery and PPI therapy.

Findings

The cure rate was 76.19% with an overall efficacy rate of 92.86%.

The treatment required an average of 1.79 procedures per patient.

The method is simple, well-tolerated, cost-effective, and avoids general anesthesia.

Abstract

•Local anesthesia electrocautery via laryngoscopy treats RLCG.•Combining with acid-suppressing therapy boosts efficacy.•This combination shortens disease course and is highly effective.•The procedure is simple, well-tolerated, and cost-effective.•It improves symptoms quickly without general anesthesia or intubation.

Local anesthesia electrocautery via laryngoscopy treats RLCG.

Combining with acid-suppressing therapy boosts efficacy.

This combination shortens disease course and is highly effective.

The procedure is simple, well-tolerated, and cost-effective.

It improves symptoms quickly without general anesthesia or intubation.

To evaluate the clinical efficacy of high-frequency electrocautery under electronic laryngoscopy combined with acid-suppressing drugs (Proton Pump Inhibitor, PPI) in the treatment of Refractory Laryngeal Contact Granuloma (RLCG).

A total of 42 patients with RLCG, treated at our hospital from January 2019 to January 2024 were included in this study. The patients underwent high-frequency electrocautery to excise laryngeal granulomas under local anesthesia using electronic laryngoscopy, followed by PPI therapy. Follow-up started one-month post-surgery and lasted for 6–12 months (average of 8.5 months), to assess the cure rate and overall efficacy.

The cure rate was 76.19%, and the overall efficacy rate was 92.86%. On average, each patient underwent 1.79 procedures. The combined treatment of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy demonstrated significant therapeutic effects for RLCG. The treatment was simple, well-tolerated by patients, cost-effective, and resulted in rapid symptom improvement, all without the need for general anesthesia or intubation.

The combined approach of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy is effective in treating refractory laryngeal contact granuloma. This method offers the advantages of a straightforward surgical procedures, high patient tolerance, low cost, quick symptom relief, and no requirement for general anesthesia or intubation.

Level 4-Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.

Figures