A granuloma is a buildup of scar tissue in either the back of the vocal folds or along their surface. It is most often caused by a minor injury in the presence of laryngo-pharyngeal reflux.

Overview and Symptoms

Symptoms of granuloma include:

  • a feeling of having a lump in the throat, often more pronounced when swallowing
  • a tickle in the throat or sore throat
  • pain that seems to be in the ear
  • pain or irritation when swallowing
  • dry or non-productive cough

A laryngovideostroboscopy and voice evaluation are used to determine whether voice therapy and/or surgical intervention is appropriate.

During your first diagnostic visit, a speech pathologist will use a diagnostic tool called laryngovideostroboscopy to examine your vocal folds in slow motion.

On a second visit, a speech pathologist will collect acoustic measurements of your voice and have you participate in trial voice therapy techniques.


Voice therapy is much like physical therapy for any other part of the body. Sessions usually take place weekly for about 8 visits. You'll learn about the basic anatomy and physiology of the voice mechanism and about how to care for your voice. Pre-surgical counseling is provided when appropriate.

To achieve the best results, we'll provide exercises to be completed at home. We will do our best to help you figure out how to fit these practice exercises into your daily schedule.

Through practice, the body learns to make the small changes required for effective voice activation and for a smoother, easier voice. Regular practice helps to make these changes automatic so that eventually they come naturally. You may find it helpful to record your voice therapy visit using you smart phone or other recording device to aid with home practice.

If you need surgery, voice therapy may occur either before or after surgery takes place. After, you will have a final voice re-assessment and laryngovideostroboscopy.

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The Voice, Speech and Swallowing Therapy experts at BIDMC are nationally recognized leaders, specializing in the diagnosis and treatment of voice, airway, speech and swallowing conditions.

Voice, Speech and Swallowing Therapy