Contact Ulcer of the Larynx

The etiology, pathology, and treatment of contact ulcer of the larynx were studied in 92 patients whose ages ranged from 28 to 72 years. There was a significant preponderance of males over females (84 to 8). The most important etiological factor was the vocal strain of shouting against noise or talking under other adverse conditions. The lesions appeared as ulcers on those cartilaginous parts of the vocal cords that touch during phonation. Granulomas developed in the chronic cases, and some became extremely large. The symptoms included hoarseness and pain. Therapy began with voice rest and elimination of oral infection; these combined with vocal reeducation sometimes sufficed to bring about improvement. Surgical removal of the granuloma under direct laryngoscopy was done in 42 of the 92 patients. No cautery, either chemical or electrical. should be used.