Vocal process granulomas (VPGs) are common benign exophytic lesions of the posterior larynx that can occur secondary to intubation injury, laryngopharyngeal reflux or voice abuse. Notorious for their tendency to recur, a conservative surgical approach can be tempting to employ for posterior laryngeal lesions that have the clinical hallmarks of VPGs, given that trauma through operative trauma is felt to predispose to worsening of the condition. This paper serves to caution against a non-operative approach at the outset for posterior laryngeal lesions that appear endoscopically to represent VPGs. Two cases of patients with posterior laryngeal lesions are presented, both with a preceding history of intubation and nasendoscopic findings (included in the paper) that appeared to be in keeping with a diagnosis of VPG. Although narrow band imaging (NBI) revealed a suspicious vascular pattern for the first patient’s lesion, the second patient’s lesion appeared uniformly white on NBI. Histological analysis of both lesions revealed squamous cell carcinomas. Appropriate oncological treatment was subsequently offered with no recurrence noted at two-year follow-up. In light of these cases, the authors recommend early biopsy or complete resection of posterior laryngeal lesions for a definitive histological diagnosis, especially when such lesions are large or extend beyond the vocal process. Given the implications of a missed or delayed cancer diagnosis, it is hard to argue with this recommendation for the vast majority of patients.
Wolves dressed like sheep – why posterior laryngeal lesions should (almost) always be biopsied
Top Of Page
Accreditations
Pinpoint Scotland Ltd (Registered in Scotland No. SC068684) | © 2026 - Website by Gecko Agency