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ENT · Larynx: contact granuloma
Sample itemA man with chronic reflux and throat clearing has a granulomatous mass at the vocal process of the arytenoid. What is the most appropriate first treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Proton pump inhibitor with voice therapy
Contact granuloma arises at the vocal process from trauma, reflux and voice abuse. Medical management with acid suppression and voice therapy is first-line, as excision often recurs.
Option by option
A. Proton pump inhibitor with voice therapy (correct)
Correct. Treating reflux and voice misuse is first-line.
B. Immediate laser excision
Excision alone often recurs.
C. Tracheostomy
Tracheostomy is not needed.
D. Radiotherapy
Radiotherapy is not used.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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