A vocal process granuloma is a benign inflammatory lesion that usually occurs in the posterior aspect of the vocal fold where the cartilage attaches to the muscle. It may occur following surgery where a breathing tube is placed through the voicebox to secure the airway for general anesthesia. Alternatively, it can occur following significant voice use and strain.

Both pathways result in injury to the mucosal lining near the cartilage that results in an intense inflammatory reaction and the formation of a benign mass. The size of the granuloma can vary.

The diagnosis is made by taking a complete history and carefully examining the vocal cords either by flexible laryngoscopy (a flexible camera placed through the nose) or a videostroboscopy (a flexible or rigid exam of the vocal cords which allows for examination of the vocal fold mucosal wave).


Management is based on the reason why the granuloma occurred. Routine treatment involves management of laryngopharyngeal reflux (LPR). Additional interventions may include referral to a Speech-Language Pathologist for voice therapy, a Botox® injection to weaken the vocal folds, or possibly surgical excision of the granuloma in the operating room.

The information contained on this website is intended for educational purposes only and is not intended to diagnose and/or dictate treatment for any disease process. Please consult your physician for management tailored to your specific condition.