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Comparison of the effects of esomeprazole plus mosapride citrate and botulinum toxin A on vocal process granuloma.

Abstract：

OBJECTIVES:Vocal process granulomas have a high tendency for persistence despite many treatment alternatives. Anti-reflux medications or botulinum toxin A injections are the main current therapies. There are no studies that compare the effects on vocal process granuloma of proton pump inhibitors plus prokinetic agents with botulinum toxin A injections. STUDY DESIGN:Prospective cohort study. METHODS:Adult patients reporting to our outpatient department complaining of trachyphonia and/or abnormal pharyngeal sensations who were found to have contact granulomas. Patients were divided into two groups according to the treatment: esomeprazole with mosapride citrate (n=26) or botulinum toxin A injection (n=20). The reflux symptom index and reflux finding score determined by electronic fibrolaryngoscopy were utilized to assess efficacy. RESULTS:Forty-six patients were recruited (43 male; 3 female). The mean age (range) was 48.3years (38-69) and the body mass index was 23.51kg/m2 (19.13-27.89). Laryngopharyngeal reflux disease diagnosed by RSI or RFS was found in 18 and 27 patients, respectively, and 18 diagnosed without laryngopharyneal reflux disease. Twenty patients (95%) were cured in the esomeprazole with mosapride citrate group and nine (45%) in the botulinum toxin A group. Eleven (55%) patients had recurrence after botulinum toxin A injection, with an average interval of 3.1months (range 1-6). The recorded symptoms after therapy resolved within 6months with a statistically significant improvement in the esomeprazole with mosapride citrate group. CONCLUSIONS:Combined proton pump inhibitor plus prokinetic drug therapy plays a significant role in the treatment of vocal process granulomas or after surgery.

journal_name

Am J Otolaryngol

journal_title

American journal of otolaryngology

authors

Lei L,Yang H,Zhang X,Ren J

doi

10.1016/j.amjoto.2017.01.039

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

593-597

issue

5

eissn

0196-0709

issn

1532-818X

pii

S0196-0709(16)30415-X

journal_volume

38

pub_type

杂志文章

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