Reflux of gastric contents may also cause contact ulcers. Mild pain with phonation and swallowing and varying degrees of hoarseness result. Biopsy to exclude carcinoma is important. Prolonged ulceration leads to nonspecific granulomas that also produce varying degrees of hoarseness. Patients must recognize the limitations of their voices and learn to adjust their vocal activities to avoid recurrence.
Granulomas tend to recur after surgical removal but respond to voice therapy.
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