Vocal Granulomo Heal Time

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Hiya smile

Wondering if anyone has any experience with vocal granulomas and can tell me how long they usually take to heal -- assuming the underlying causes (Acid reflux in my case) are addressed?

Had one for around 6 months now and it's refusing to shift!

Cheers

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  • Posted

    One thing I can tell you is that anything to do with the voice box takes an incredibly long time to heal, and that is only once you've dealt with the underlying problem. I wouldn't doubt that could take you between 1 and 2 years. What are your symptoms.? Are you diagnosed with LPr?

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    • Posted

      Hiya,

      Thanks for the reply! Appreciate you responding to me.

      The symptoms I have are:

      *Feeling of phlegm stuck in the side of the throat where the granuloma was found

      *Constant urge to clear my throat

      *Scratchy feeling whenever I talk for more than a few mins which gradually causes neck and ear pains when I talk for about 30 mins straight

      I've been diagnosed with a Hiatus Hernia about 10 years ago and used to suffer badly with acid which is now better due to lifestyle changes etc. But that doesn't mean I don't have LPR.

      I've had 3 ENTs carry out 6 Nasendescopys to view my throat, 1 rigid one which was carried out under General Anaesthetic and finally a HD Stroboscopy. It was the Stroboscopy that found the small granuloma and also a "cobblestone appearance" to my Oesophagus which I'm told isn't normal and is like lots of mini granulomas caused by acid.

      I was put on 80mg of Omaperazole a day, 3 lots of Gaviscon Advance a day and also 300mg of ranitidine a day to help combat the acid.

      Interested to hear your opinion on my issue given the above info.

      Cheers 

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  • Posted

    Interesting. I wonder if it has anything to do with reflux, lpr. I'll first mention some of mine then share my theory. I have very similar symtoms on the left side only! Throat clearing most of the day probabaly 200 times so I chew gum like mad. The ache in the throat on that side and the pain that radiates to the ear is what drives me crazy, it's never there in the morning but then revs up in 30 min, talking kills me and Amps everything up. Painkillers dont work at all! Wierd neck feelings also on that side. I've had 3 scopes and gastroscope and bloods, thyroid etc. Stomach is good, tight LES and perfect pipe. Other than general redness in the larynx on the first 2 scopes we at this point dont know what's going on. It sure feels like an acid burning sensation right at the top of my voice box and when I breath in everything from my tongue to deep in voice box is sensitive to the colder air. Drives me nuts. I suspect that yours as well as mine could very well be the result of nerve damage in the throat! You cant underestimate the problems this can cause in the mobility of the esophagus! Then reflux happens likely for 2 reasons, cause your worried and always focused on the damn throat and because of the mobility issue. The reflux which is likely very small then makes the nerve go nuts. It's a double edge sword. I dont have any real answers but am still ongoing with the ent. Lpr may have nothing to do with it? Many doctors say what's that? Here in Canada it could be a tough diagnosis. The nerve gets ravaged by an infection, but I think you would have noticed when that happened. I did. I dont know much about granulomas, but again the larynx of that's where yours is takes forever to heal. So strange. Gaviscon advance, which isn't available here I had to order, did do anything for me. I also did ranitidine for the last month, same thing.. nothing. I'm 40 male fyi. And very athletic. Maybe that's my issue..lol. I also have really watched the acidic foods and pretty much cut them all out for months. Do you get any burning sensation? How did this all start for you? Maybe my answer isnt much help but at least it starts a discussion.

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    • Posted

      How very odd!!! It seems we have almost EXACTLY the same issue! Will reply to your message in sections to make it easier for you to read.

      I too have it on the left side only, like an inch to the left of the sticky out bit on my adams apple. This is EXACTLY where the granuloma was found also. A granuloma is just damaged tissue from acid or trauma which is similar to a cyst but it's hard-ish and takes ages to go away.

      I too have the throat clearing "need" hundreds of times a day. For this...do your very best to NOT clear your throat. Clearing actually made mine worse and made the need to clear my throat happen more often. It's still always there but way better no I resist the urge.

      Also, I am the same as you, I feel fine firs thing in morning but within half an hour it's back again even if I don't eat/drink or talk. Can only assume it's had time to rest (in both of our cases) and some act of being awake causes signals to be sent to remind us it's there? Not sure.

      Good news on your scopes!! Means even if yours is caused by acid (which it could be as they saw redness which indicates acid damage lower down which could mean it made it to your throat) that you can deal with it easier as you've no serious underlying cause which I do so it's harder to keep the acid reflux at bay.

      Funny you should mention the nerve damage, I did read online about folks damaging the vegus nerve in their throat which lead to all sorts of odd feeling and symptoms in the throat...If it's that, then it's going to be tricky to deal with.

      Well, I still feel that in myself (based on my results) and you (based on what you've said) that LPR or even standard acid reflux could have caused the damage in the first place which is leading to our issues now...even if LPR and Acid are no longer occurring.

      I'll say that Gaviscon and all my other tablets have done nothing either, but then again, they're not designed to fix the issue we are reporting, they're designed to supress the cause of the issue (acid) which then gives the damaged area time to heal.

      I don't get any burning now no, I used to have it a lot many years ago which is why I know I suffer with acid (along with the tests confirming it). 

      Funny you should ask about how it started...I can almost pin point the exact day! I had a heavy meal one evening along with some wine, I woke in the morning with a sore throat but it wasn't like a normal sore throat, it felt like my throat was burning! It went away though within about 4 hours...

      I was left with a lump feeling in my stomach which I've had in the past which was proven to be caused by acid reflux damage in my food pipe which reddened the area. About a week later that also went but I was finally left with the throat problem...

      How did yours start and how long have you had it for?

      BTW, I too have had blood tests, thryroid tests and also an ultrasound on my throat which revealed nothing.

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  • Posted

    Thank you for your reply, Below is a post that I put up a week or so ago, still no replys, however there is a but more detail for you. My wife is starting to think it's all in my head. I wish it was, it makes me cranky and even at times tired and hard to get motivated. Stopped the ranitidine 150 twice per day and, seeing the ent friday. Let me know your thoughts and feel free to ask anything! Fyi I've seen 2 doctors and 2 specialists, they have all suggested reflux except the gastrointestinal guy he just shrugged...lol but none have given me a solid diagnosis.

    . I'm in the same boat although slightly different. I suspect everyone's symptoms dont present the same! Hope people have time to read this. Yes all this messes with your head there is no doubt. At the end of the day I'd like to meet anyone who doenst have some level of health anxiety. I'll try and best describe my issue and maybe it will help you and other also. At current I have a very odd burning sensation in my larynx when I talk, it gets worse the more I talk also. I'm self employed and this makes it extremely difficult to talk to clients, i tend to avoid talking to people because of this which sucks. Some symptoms and then a little history. Male in the early 40s, dont smoke, very athletic and eat well. Burning sensation localized on left side only of larynx in a specific spot beside my larynx. This pain area cant really be felt on the outside with my hand but I sure can feel it when I breath in oddly enough! Sometimes when I relax I almost feel normal. I also get this cold air feeling throughout my mouth and tongue which is worse somedays than others, (this may be anxiety but I'm not so sure yet as it's never presented this way). The left side of my larynx feels like I have a knife stuck in it from about 8am till 10pm. This odd ache and hot sensation seems to travel towards my ear on the same side and I swear I can feel it in my teeth. Neck muscles a slight bit sore also same side. Sometimes I feel a wierd tickling left side chest, this all seems to send some wierd charge and somewhat electrify my whole body as if its an anxiety feeling. So strange how they seem tied together. This all started after what I think was some sort of viral throat infection left sided (I could see it when I looked way down) June 2017 over 1 year ago, one thing to note the wildfires were so bad that year...months of thick smoke makes me wonder. My symptoms have changed throughout this year period and some have come and some have gone. One strange one I'll never forget in my whole larynx cramped up for like 3 months. Lifting my chin up and putting it to my chest felt very tight and delivered a slight bit of pain. Talking was such a fricken strain you wouldn't believe it. If i tried to sing a higher note...wham it almost dropped me to my knees always left side Layengeal muscle, that's a bit better now but if I sing I'll pay for it for 2 days so I dont bother. During this time I actually thought I was on my way out, I'm still not so sure...lol! In the beginning it took me 2 months to finally see a doctor, he looked in my mouth said it's not a bacterial infection and shrugged his shoulders, my fault for probably going in to emerg at 12Am guess I panicked but I was going on a trip where there was no communication for 10 days... Then when I returned I fought this thing with garlic and ginger etc etc for months and it wouldn't let up left side always...finally I went into the clinic in that Dec...throat was all red. Well of course here come the ppi's as he figured I had reflux. At this time it felt like my head was gonna pop off and I had a belt strapped around my neck! Ha. Very scary let me tell ya! When ppi's did nothing then he said it was anxiety and depression...well no kidding after all this. He tried to get me to take anti depressants which I did for 7 days and it felt like my skin was on fire so forget all that. Since about January till now ive watched what I eat big time, I've had blood work including thyroid...all perfect. 3 larynx scopes saw a bit of inflamation on first 2 but all looks fine on the last. 1 endoscopy w/ stomach biopsy, tight lES etc.....nothing. they just shrug their shoulders. Now I'm scheduled for an ultrasound and more talk with the ent. We will see, my last visit with him he suggested Spamatic Dysphonia. My gut and research tells me that I have nerve damage somewhere left side of my larynx. I'm not sure of LPR but I haven't ruled that out yet as it seems it can be very complex. Nerve damage can reek havoc on these delicate systems so who knows if its causing some type of relfux. I'm pretty sure I had muscle tension dysphonia for 3 months there...wow. Maybe this all has a neurological component to it...why wouldnt it after all of that! Still at the end of the day I had something happen left side of throat deep down into where my Arytnoid of my larynx is, maybe its chondritis, Maybe I'll never know...fyi otc pain killers do very little if nothing and im totally fine when I sleep and for about 30 minutes in the morning till thing cranks up. Sure makes you focus on the pain, changes your whole perception on life and how people must suffer. Maybe not a bad lesson but I think by now I've learned mine.

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    • Posted

      Hiya

      Yeah, I've been there also with people thinking and stating it's all in my head...at least with me though, I've seen the minor granuloma so know something is there...whether or not it's causing all of the issues I'm having though, even the ENT who spotted it wasn't sure.

      I feel your pain though, with you no one has even seen anything (which is both good and bad!) but I do believe and have read articles on nerve damage in the throat causing issues like ours.

      I know what you mean about it impacting your life also, I too spend a lot of time talking in my job and the throat problem has made me less confident and makes me want to avoid conversation as much as possible which isn't like me at all.

      Interesting to see you mention HA also, I too have this and have done for most of my life...I guess with both of us, this is why people claim it's in our heads...but it's not! When we have un-diagnosable issues for months on end, it makes us seem like we are making it up but that's not true.

      You state that you get burning feelings, this is very common for acid related issues which have damaged the voice box and made it sensitive. I do not have this issue but have read many articles online which cover this topic. The pain from your throat to your ear is something that vocal cord ulcers and vocal granulomas can cause also, you may want to consider seeing an ENT who specialises in vocal disorders, it was one of these that used the HD Stroboscopy to find my granuloma which is more than any of the other 3 ENTs were able to do with all of their scopes.

      Really difficult to tell what is causing your issues TBH, could be acid, could have been an infection or could be something different altogether. All I can do is suggest you see a vocal specialist and don't waste time seeing general ENTs time and time again like I did for 5 months. Some area great but a lot have a habit of doing the basic acid checks and claiming any redness is cause for a 2 month dose of PPIs which MAY work but they haven't really do enough to rule anything else out as they haven't found the problem causing your voice box pain.

      Likewise with the pain killers, they do nothing for me...I even got put on a month long dose of antibiotics, they did nothing either.

      I will defo keep replying to you but I can't offer to have answers for you I'm afraid as I too haven't gotten to the bottom of my issue. I'm booked back in next month with the vocal specialist to see if the granuloma has changed then he said he may send me for a stomach acid PH test (these look horrible, I don't want one) followed by another endoscope to see if my hiatus hernia has gotten worse (it's what's causing my acid reflux in the first place).

      Have you had an endoscope BTW? Right down to your stomach that is to see if you too have a hernia?

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  • Posted

    Well I saw the ent again. I sat there and told him as much as I could about my symptoms, pain, theory on what it may be, etc. PVVN, LPR....He had a look through my nose again at my larynx and said it looks perfect and less red than before. He doesnt want me on any medication as he says it only masks the problem and he want to know what's causing it. I have had a bit of a shift in the past while in my vocal fatigue, it seems to be a lot less and getting better very very slowly, essentially I have much more endurance in my voice. But the ache from my left arytinoid towards the left ear on the one side prevails. Along with the throat clearing and slight burning sensation in the upper voice box. His diagnosis....self manifested airway reflux! Stress! Come see me in 6 months if it doesnt get any better. Keep in the low acid diet to some degree and dont eat 3 to 4 hours before bed. Excersise is key as well. These are all things he said. Yes I did get a gastroscopy and biopsy of the stomach...nothing all 100%. This is my 4th laryngoscopy and it went from red to a lot less red over 6 months. I do and dont have any real answers so I guess I'm left to battle this till it either kills me or goes away. No ppis as he says they will create a problem with reflux that may have not been there in the first place. Seems like a lot of people are being treated with low doses of trycyclic antidepressants for lpr. Who knows. Interesting anyhow.

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    • Posted

      How very odd!! You seem to have most of the same symptoms as me but without the underlying cause and history of acid reflux which I have.

      I mean I guess it should re-assure you....but if you're like me (and it seems you are) then I know it won't really have done much to help you as the issue is still there and so is the frustration that nothing has been found.

      Good news on the vocal endurance front! I sort of know what you mean as I can sometimes talk a little longer than I used to be able too without the pain coming back as quickly or as intense, but like you, it seems to be VERY slow.

      Yep, I feel the same...either it's live with it and cope as best we can until either it goes away one day or turns out it was something serious (I don't wish this on either of us!) and kills us off eh!! sad

      You going to try the antidepressants then? And how long did you say you'd had the issue for again?

      I've got a bit of a weird one with my throat which has happened twice in the past two weeks, whenever I overuse my throat during a day (too much talking usually), I'll wake up with a sort throat and a swollen gland ONLY on the side where my throat issue is. The swelling and sore throat will subside by lunch time...how odd is that! 

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  • Posted

    I've had this issue for 15 months now. It has gotten better but ever SO slowly. No antidepressants here! Never! I have found that cbd oil helps with the pain, I have been taking a full dropper at night, not only do you sleep like a log but it seems to help with the pain the next day, I dont take it day time as I find I'll get a bit drowsy mid day. The ent said that he sees airway redlflux daily in his office and let's ut run its course, says its stress induced and self manufactured! Takes a long time to get over it....many months to years. Also says that it affects everyone different with different symptoms! Oddly enough the pain I feel on the left side of the addams apple seems tied to my anxiety center as if there is a string running through my body and something is yanking on it causing odd sensations and pain.... lol. That ranitidine made my hearing muffled, I think it's going away after a week or so. How old did you say you were? One doctor I saw a couple months back told me to "shut up" and not talk for 30 days...not 1 word. He said what do you think happens to singers. Who knows...I could have sworn I had a baseball tumour in my voice box by the feeling and pain I had but nothing there and I've also been told by doctors that anything bad doesnt present like that.

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    • Posted

      I feel for you! I've had mine 6 months and it's driving me mad! Can't say I've heard of that oil, but I don't really get any lingering "pain", only when I'm talking and then when I stop, I'm left with the feeling of phlegm stuck.

      Hmmmm, I guess some part of what the ENT said to you could well be true! But they've a habit of just not being very good at doing anything when it comes to any kind of reflux. Just send you away with lifestyle advice and pills and at best they will say come back in a few months. 

      I know what you mean, could well be nerve related in you then which is made worse by stress...I've really no idea! With me it's for sure the little granuloma causing the problems...it HAS to be as the EXACT area where I have the issues is where the granuloma is. I'll attach a pic of mine if you're sadistic and interested in it! Ha.

      I can't say I've had any side effects of any of the tablets I'm on, they don't seem to be making the issue better...but I guess with acid reflux, it COULD well be supressing the majority of it and keeping it away from the throat and thus allowing it to heal...just a lengthy process as you said.

      I'm 28, none smoker, don't really drink, work in an office.

      Yanno what...I bet he's right about the not talking for 30 days thing, I bet it would help dramatically hence why both mine and your issue gets better overnight and feels good for the first 30 mins in the morning. But with my job in IT and yours (you said you're on the phone a lot), we've no way of doing that have we! 

      I'm the same mate! I am/was sure that this is cancerous and while I've not directly asked the ENT who found the granuloma if it could be serious, he didn't seem concerned either.

      Pics of mine..Just in case you were wondering what I was referring too by "granuloma". It's actually the greyish but above the mouse cursor I think.

       

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  • Posted

    Well finally had my ultra sound....Nothing, all looks normal lymph nodes and all. For a while there I could have sworn I had some deep neck abbsess...nothing. i feel however after 14 months or so i am turning the corner yet healing is extremely slow...and I mean slow! Im chalking it all up to nerve damage from a virus that settled in my throat and all the manifestations that came with it!

    I see your picture of your voice box. Very interesting! Not a nice spot to have that! You must feel it all the time whilst talking. I wonder what's the best way to heal that! Could it be that you may have something stuck in there? A sliver of something that is irritating the area? Can you get a cat scan? Maybe spend some time in some hot saunas too breathing the moist air, may help. Let me know how it goes. I'll keep in touch as I heal!.

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    • Posted

      That's great news!!! Hopefully that's re-assured you somewhat smile As you said in the past, this will take a long time to heal and the thought of your comment along with WHY it would take this long to heal is actually what's stopping me going completely mad with this issue myself.

      I'm glad to hear yours is getting ever so slightly better, even if it is a slow road to recovery. It could well be what you said, nerve damage is impossible to visualise isn't it so no wonder no one has been able to see anything wrong with you. So have you stopped taking tablets full stop now then?

      I know right! Right between the fold of the two areas isn't it!! I am re-assured more now I've seen those photos and the ENT didn't seem concerned either, I still worry when I have an issue for this long which refuses to shift but there's not much else I can do now I don't think. 

      I could get a CAT scan but I'd be stuck paying for it myself, these throat scans are around £800 each which I have to pay for (and my ENT wants a second one to be done in 3 weeks time to asses it again) and a CAT scan is around £1500-£2000, I just don't have the money sad

      I actually have spent a little time in some saunas and it didn't do much to relieve it TBH, the ONLY thing which relieves mine is sleeping and NOT talking, if I manage to go a whole day without speaking (very hard with work and a wife), I feel like it's almost gone! Then 20 mins of talking and it's right back to square 1 again.

      I need to do as your Dr suggested and shut up for a month! Ha.

      I will do! Will report back as to what the results are of my next ENT stroboscopy, please do keep responding as and when your symptoms change and get better (hopefully!) as it seems there's no one else out there ATM with issues similar to ours.

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    • Posted

      Hey!

      Just wanted to update you as promised regarding the results of my 2nd Stroboscopy.

      We sat there and compared the video footage of the test 2 months ago and the test 2 days ago and it was clear that the damage I showed in the photo I posted has completely gone, my entire throat looks perfect! The doc couldn't see ANYTHING which would be causing my symptoms but said it's likely scar tissue in the vocal folds caused by acid damage which is restricting the movement of my vocal cords which in turn is causing the vocal fatigue I'm facing.

      Seems plausible! Not much can be done though short of either vocal training to loosen the scar tissue or surgery to correct it.

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  • Posted

    Hey there...this sounds great. Time I guess is what it takes. Hard when a person has to talk each and every day. Hope you continue to do well.

    I've had my best couple weeks in the last while but do have down days with strange inner ear pressure in what feels like my eustatian tubes, I dont know. That same feeling like my heads going to pop off. Lol, but I have felt like I may have an touch of a cold too. Oh well. I have been strictly following the low acid diet for about 3 weeks now. I'll stay on that as I think most of my improvements have been made while I'm on it, and wow does it shave the weight. The tough part with all of this is always wondering if it really is LPR or something else and why it happened. What else could it be? Keep in touch.

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    • Posted

      Hey! I'm sorry for not replying in a while! My vocal problem is still as bad as it was even though the last Stroboscopy looked clear...I'm very fed up now! I'm pursuing voice therapy now to see if that helps as I'm totally out of ideas!

      It gets so bad when I talk a normal amount that I don't know how I can continue living with it 😦 And as you say, the worry of it being cancer or something serious doesn't help either. Along with not knowing what caused it, if you're making it worse (or preventing it healing) but not doing a certain thing (or the opposite!).

      How are you getting on with yours? Is it better at all after your last post?

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