Laryngeal Contact Ulcers
Laryngeal 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 (see The Professional Voice). 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. Prolonged ulceration leads to nonspecific granulomas.
(See also Overview of Laryngeal Disorders.)
Symptoms of laryngeal contact ulcers include varying degrees of hoarseness and mild pain with phonation and swallowing.
Diagnosis of laryngeal contact ulcers is by laryngoscopy. Biopsy to exclude carcinoma or tuberculosis is important.
Treatment of laryngeal contact ulcers consists of ≥ 6 weeks of voice rest. Patients must recognize the limitations of their voice and learn to adjust their post-recovery vocal activities to avoid recurrence. Suppression of bacterial flora with antibiotics is also recommended.
Risk of recurrence is reduced through vigorous treatment of gastroesophageal reflux.