User:StaceyG124/sandbox

Expanding material for this article
I would like to update and expand the current article regarding differential diagnosis and treatment of contact granuloma. The following are articles that I would hope to use. Any feedback would be very much appreciated.

Differential Diagnosis
Various methods are used to diagnose contact granuloma which aid in differentiating it from other vocal fold pathology. Laryngoscopy can allow visualization of the suspected granuloma while also checking for signs of vocal abuse. Laryngoscopy, as well as an acoustic analysis of the voice, can help rule out vocal fold paresis as an underlying cause. Microscopic examination of the tissue can help determine that the lesion is benign rather than cancerous, as would be the case in contact granuloma. Other methods such as laryngeal electromyography and reflux testing can also be used to evaluate the function of the vocal folds and determine if laryngopharyngeal reflux is contributing to the pathology.

Treatment Overview
Specific treatment for contact granuloma depends on the underlying cause of the condition, but often initially includes a combination of speech therapy,   vocal rest,   and antireflux medication. A more aggressive treatment approach could include steroids (inhalant or injection), injections of botulinum toxin,    low dose radiotherapy, vocal fold augmentation, or microlaryngeal surgery).     Microlaryngeal surgery can be performed either via cold steel excision or various types of laser. The laser is more accurate and typically results in less damage to the surrounding tissue.  These more aggressive approaches might be used in the case of the refractory (i.e. resistant to treatment) contact granuloma where previous interventions have not succeeded or recurrence rates are high. The best outcomes appear to occur when a combination of treatments is used.