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.