GRANULOMA
3 types:
- 1. Intubation (most common)
- 2. Contact
- 3. Granulomas caused by gastroesophageal reflux.
Location:
- * At vocal processes of the arytenoid cartilage or on lateral wall of
posterior glottis.
Consist of:
- * Proliferated capillaries, fibroblasts, collagenous fibers, and
leukocytes.
- * May not be covered with epithelium
Effect:
- * No effect on mechanical properties of any layer of membranous vocal
fold.
Characteristics:
- * Normal symmetry, maintained uniformity, no glottic incompetence,
maintained layer structure, normal cover, normal transition,
normal body, no interference.
Etiology:
- * Most commonly a complication of intubation
- * Spontaneous resolution occurs within a few weeks in most cases
incidence depends on
duration of
intubation, method of intubation, Patients age and general
condition,
nursing techniques and other factors.
- * All reported cases occurred in patients 15 years and older.
- * Women are more prone
Perceptual Signs and symptoms:
- * Breathiness and hoarseness. Some may not affect phonation due to
their location.
Acoustical Signs:
- * No data on acoustic characteristics
- * Greater than normal frequency and amplitude perturbation would be
expected
- * And depending on the severity of the hoarseness, greater than
normal Spectral noise could be present.
Measurable Physiological Signs:
- * Normal air flow rates
Observable Physiological Signs:
- * Irregularly shaped masses of tissue
- * Normal stroboscopic signs unless granuloma appears on vocal fold
margins
Pathophysiology:
- * Intubation granulomas primarily affect the mucosa of the vocal
processes of the arytenoids.
Laura Miller, 1997