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 The Professional Voice Laryngeal contact ulcers are unilateral or bilateral erosions of the mucous membrane over the vocal process of the arytenoid cartilage. Laryngeal contact ulcers are usually caused by voice abuse... read more ). 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 Vocal Cord Polyps, Nodules, and Granulomas Acute trauma or chronic irritation causes changes in the vocal cords that can lead to polyps, nodules, or granulomas. All cause hoarseness and a breathy voice. Persistence of these symptoms... read more .
(See also Overview of Laryngeal Disorders Overview of Laryngeal Disorders The larynx contains the vocal cords and serves as the opening to the tracheobronchial tree. Laryngeal disorders include Benign laryngeal tumors Contact ulcers Laryngitis Laryngoceles read more .)
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 Treatment Incompetence of the lower esophageal sphincter allows reflux of gastric contents into the esophagus, causing burning pain. Prolonged reflux may lead to esophagitis, stricture, and rarely metaplasia... read more .