User:Sbogdanovitch/sandbox

Historical Perspectives
Several terms are used to refer to vocal process granulomas (contact ulcer, contact granuloma, vocal fold granuloma, etc). The term contact ulcer was first used in the early 20th century at which time the single cause of this condition was believed to be excessive force when the vocal folds make contact during phonation or non-phonatory behaviors (i.e. coughing). Later, the same condition was observed in patients recovering from recent intubation and, more recently, is associated with inflammation and irritation resulting from gastro-esophageal reflux. The term vocal process granuloma is preferred today over the term contact ulcer or contact granuloma; this reflects the fact that this condition can result from a variety of different causes and not just excessively forceful contact of the vocal folds as originally believed.

Physical characteristics
Contact granulomas can be physically identified and diagnosed by observing the presence of proliferative tissue originating from the vocal process of the arytenoid cartilage. Identification is carried out by laryngoscopy, which produces an image of the lesion in the form of an abnormal growth (nodule or polyp) or ulceration. The vocal process is overwhelmingly the most common laryngeal site for these lesions, although they have also been observed on the medial and anterior portions of the vocal folds. In nodule or polyp form, contact granulomas generally have a grey or dark red colouring and measure 2 to 15 mm in size. Contact granulomas can occur unilaterally or bilaterally, affecting one or both vocal folds.