On occasion, patients may develop a benign growth, called a granuloma, along the back portion of one or both vocal cords. When this growth becomes large, it can become painful to speak or swallow, and if large enough, it can prevent the vocal cords from closing properly during voice production.
Depending on the circumstances, it can sometimes be futile to remove this growth surgically, since it tends to recur unless the vocal trauma that caused it to develop in the first place is reduced. Fortunately, botulinum toxin (Botox) can be helpful to reduce the collision trauma between the back part of the vocal cords and therefore lead to resolution of persistent granulomas. Botulinum injections for a laryngeal granuloma can be performed in the office, without sedation.