Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis

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#combined-modality-therapy #granuloma-laryngeal #humans #intubation-intratracheal #recurrence

Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis

Rimoli et al., 2018 | Braz J Otorhinolaryngol | Meta Analysis

Citation

Rimoli Caroline Fernandes, Martins Regina Helena Garcia, ... Catâneo Antonio José Maria. Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis. Braz J Otorhinolaryngol. 2018;84(6):781-789. doi:10.1016/j.bjorl.2018.03.003

Abstract

INTRODUCTION: Laryngeal granulomas post intubation are benign but recurrent lesions. There is no consensus for its treatment. OBJECTIVE: To describe the effectiveness of different treatment modalities for primary or recurrent laryngeal granulomas resulting from endotracheal intubation. METHODS: Systematic review and proportional meta-analysis. Eligibility criteria - experimental or observational studies with at least five subjects. Outcomes studied - granuloma resolution, recurrence, and time for resolution. Databases used - Pubmed, Embase, Lilacs, and Cochrane. The Stats Direct 3.0.121 program was used. RESULTS: Six studies were selected, with 85 patients. The treatments registered were: antireflux therapy, speech therapy, anti-inflammatory drugs, steroids, antibiotics, zinc sulfate and surgery. 85 patients from six studies had primary treatment: surgery±associations (41 patients), resolution chance 75% (95% CI: 0.3-100%, I2=90%), absolute relapse risk 25% (95% CI: 0.2-71%); medical treatment (44 patients), resolution chance 86% (95% CI: 67-97%); and absolute relapse risk 14% (95% CI: 3-33%). There was no significant difference between groups. Three studies, encompassing 19 patients, analyzed secondary treatment (failure or recurrence after primary treatment); three subjects presented new recurrence. The time needed to resolve the lesions varied from immediate, after surgery, to 23 months, for inhaled steroid. CONCLUSION: There is no evidence of high quality that proves the efficacy of any treatment for laryngeal granulomas resulting from endotracheal intubation.

Key Findings

Six studies were selected, with 85 patients. The treatments registered were: antireflux therapy, speech therapy, anti-inflammatory drugs, steroids, antibiotics, zinc sulfate and surgery. 85 patients from six studies had primary treatment: surgery±associations (41 patients), resolution chance 75% (95% CI: 0.3-100%, I2=90%), absolute relapse risk 25% (95% CI: 0.2-71%); medical treatment (44 patients), resolution chance 86% (95% CI: 67-97%); and absolute relapse risk 14% (95% CI: 3-33%). There was

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size 85
Age Range See abstract
Condition See abstract

MeSH Terms

  • Combined Modality Therapy
  • Granuloma, Laryngeal
  • Humans
  • Intubation, Intratracheal
  • Recurrence
  • Time Factors
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: zinc

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09