Botulinum Toxin Injections Into the Lateral Cricoarytenoid Muscles for Vocal Process Granuloma

Document Type


Publication Date



Objective Contact granulomas are benign, exophytic inflammatory lesions of the larynx that typically arise on or near the vocal process of the arytenoid cartilage. The most common management options include voice therapy and antireflux pharmacotherapy, intralesional steroid injections, botulinum toxin injections, and surgical excision. In-office Botox injection into the lateral cricoarytenoid (LCA) muscle can be effective even for recurrent granulomas.

Study Design This is a retrospective chart review and literature review.

Method We reviewed more than 400 charts and included two patients, who underwent in-office injection with botulinum toxin A into LCA muscles bilaterally, after previously failing both conservative and surgical management.

Results Both cases showed significant improvement of the laryngeal granulomas after 6 months and a single botulinum toxin injection. Both cases were initially grade III granuloma that improved to grade I.

Conclusions In-office injection of botulinum toxin A targeting the LCA muscle appears to be a safe and effective treatment modality in refractory laryngeal granuloma.


This article was published in Journal of Voice, Volume 32, Issue 3, pages 363-366.

The published version is available at

Copyright © 2018 The Voice Foundation.

This document is currently not available here.