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Laryngeal contact ulcers are unilateral or bilateral erosions of the mucous membrane over the vocal process of the arytenoid cartilage.
Contact ulcers are usually caused by voice abuse in the form of repeated sharp glottal attacks (abrupt loudness at the onset of phonation), often experienced by singers. They may also occur after endotracheal intubation if an oversized tube erodes the mucosa overlying the cartilaginous vocal processes. Gastroesophageal reflux may also cause or aggravate contact ulcers. Symptoms include varying degrees of hoarseness and mild pain with phonation and swallowing. Biopsy to exclude carcinoma or TB is important. Prolonged ulceration leads to nonspecific granulomas that also cause varying degrees of hoarseness.
Treatment consists of ≥ 6 wk of voice rest. Patients must recognize the limitations of their voice and learn to adjust their postrecovery vocal activities to avoid recurrence. Granulomas tend to recur after surgical removal. Risk of recurrence is reduced through vigorous treatment of gastroesophageal reflux (see Esophageal and Swallowing Disorders: Gastroesophageal Reflux Disease (GERD)). Suppression of bacterial flora by antibiotics during postoperative healing is also recommended.
Last full review/revision July 2008 by Clarence T. Sasaki, MD
Content last modified July 2008
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