User:Val slp123/sandbox

 Surgery 

When all other medical and behavioural treatments have been attempted, surgical removal of the contact granuloma is possible as a last resort option. However, caution needs to be exercised, especially in the cases of contact granuloma resulting from external factors (i.e., when factors are eliminated, the contact granuloma resolves independently), because any irritation can cause the contact granulomas to reappear.

(For the causes section): In addition, the presence of the contact granuloma makes it impossible for the vocal folds to come to a complete closure in adduction. This causes the person to use more force when speaking in an attempt to close the vocal folds completely, which in turn creates more trauma to the vocal folds.