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Topical inhalant steroid (budesonide, Pulmicort® nasal) therapy in intubation granuloma

Published online by Cambridge University Press:  29 June 2007

Hwan-Jung Roh
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Eui-Kyung Goh
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Kyong-Myong Chon
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
Soo-Geun Wang*
Affiliation:
Department of Otolaryngology, College of Medicine, Pusan National University, Pusan, Korea.
*
Address for correspondence: Soo-Geun Wang, M.D., Department of Otolaryngology, Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Pusan 602-739, Korea. Fax: 82-51-248-1248

Abstract

Intubation granuloma of the larynx is an iatrogenic disease which is induced by endotracheal intubation. It has basically been managed by conservative medical treatment with observation. Surgical excision can be considered as a last resort due to the high recurrence rate which subjects the patients to repeated anaesthesia. The purpose of this study is to evaluate the therapeutic effect of topical steroid in intubation granuloma, comparing the results of conservative medical treatment with, or without, surgery (Group I, 14 patients) and inhalant therapy with topical budesonide (Group II, 20 patients).

In Group I, complete disappearance of granuloma occurred in six cases within a year (42.8 per cent) with conservative therapy only. Microlaryngeal surgery was performed on the eight cases of persisting granuloma after conservative therapy for a year, resulting in two cases of recurrence. In Group II, the granuloma disappeared completely in 85 per cent within six months and in 95 per cent within 12 months without any remarkable side-effects. We concluded that intubation granuloma of the larynx could be treated with topical inhalant steroid as the first choice of therapy rather than other medical treatment or surgical intervention.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

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