User:Chelsea.osei/sandbox

New material
I will expand on aetiology and symptoms of contact granuloma.

Chelsea.osei (talk) 02:08, 1 October 2017 (UTC)

Signs and symptoms
The primary symptoms of contact granuloma include chronic or acute hoarseness of the voice and vocal fatigue. More severe granulomas may result in throat ache or soreness, as well as pain that lateralizes to one or both ears. Smaller granulomas may result in a tickling sensation or slight discomfort.

Signs of contact granulomas are frequent coughing and throat-clearing. Some people may also notice that their pitch range is restricted due to granuloma.

Causes
The major etiologic factors of contact granulomas have been organized into the following categories:

Mechanical Issues
Mechanical issues resulting in contact granulomas are related to physical trauma at the level of the vocal folds. Trauma occurs when adductive forces are excessive, meaning that a person's vocal folds are closing abruptly and forcefully while speaking or engaging in other non-vocal behaviours (such as throat-clearing and coughing). Glottal insufficiency (when the vocal folds cannot close completely, often due to vocal fold paralysis) can also be an underlying cause of contact granulomas.

Contact trauma can occur when a person frequently speaks at a pitch that is lower than their modal voice, especially in vocally-demanding positions like acting, teaching and singing. Research suggests that men are more commonly affected than women.

Intubation
For patients in need of tracheal intubation to receive oral drugs, an oversized tube, excessive movement of the tube, or infection can lead to contact granulomas, but this is rare.

Inflammatory issues
Inflammatory issues associated with contact granuloma include gastroesophageal reflux, allergy or infection. There is some disagreement among researchers as to whether inflammatory issues are a direct cause. Some researchers identify reflux and infection as indirect causes due to aggressive coughing that usually occurs as a result.

Psychosocial factors
People with certain personality traits and vocal patterns may be more susceptible to the development of contact granulomas. Tenseness, high-stress, aggressiveness and impulsiveness are personality traits associated with contact granuloma.