{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T22:18:17Z","timestamp":1766269097008,"version":"build-2065373602"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T00:00:00Z","timestamp":1699142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>De novo occurrence of granuloma (granulation tissue) on the membranous vocal fold is not readily explained by usual causes of granuloma at the vocal process. We describe a series of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single academic institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases were identified over a 16\u2010year period. All patients exhibited granulation tissue on pathology. Demographic details, presentation, treatment, histology, and clinical outcomes were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five patients (mean age: 74.0\u2009\u00b1\u20096.1 years, 40.0% male, 40.0% former smokers) underwent a biopsy. Persistent or recurrent granulation led to a second biopsy in 4 patients an average of 1423.5 days later, revealing a new diagnosis of squamous cell carcinoma (SCC) in situ in one and mild dysplasia in another. Further persistence or recurrence led to a third biopsy or excision an average of 302.3 days later in 3 patients, demonstrating SCC in situ in 1. An average of 2.5 biopsies were required with a mean time to SCC in situ diagnosis of 919.5 days from presentation. Two patients continued to demonstrate persistent granulation tissue on histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The membranous vocal fold is an atypical location for granuloma and portends a risk of occult malignancy. The occurrence of de novo granuloma at this site should prompt close long\u2010term clinical surveillance with a low threshold for biopsy. Consideration should be given to tissue collection in the operating room to adequately sample the lesion's base. Concern should persist even after a negative biopsy, and serial observation with repeat biopsy as needed should be pursued.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.570","type":"journal-article","created":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T04:30:33Z","timestamp":1699158633000},"page":"468-473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["De Novo Granuloma of the Membranous Vocal Fold: A Marker of Occult Malignancy"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2255-4816","authenticated-orcid":false,"given":"Christine M.","family":"Clark","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Sean Parker Institute for the Voice Weill Cornell Medical College\/NewYork\u2010Presbyterian Hospital New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yassmeen","family":"Abdel\u2010Aty","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida Tampa Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hal","family":"Rives","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Sean Parker Institute for the Voice Weill Cornell Medical College\/NewYork\u2010Presbyterian Hospital New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucian","family":"Sulica","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Sean Parker Institute for the Voice Weill Cornell Medical College\/NewYork\u2010Presbyterian Hospital New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348942803700117"},{"key":"e_1_2_8_3_1","first-page":"67","article-title":"Contact granulomas of the larynx","volume":"251","author":"Shin T","year":"1994","journal-title":"Eur Arch Otrhinolaryngol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00346-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310201004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.42.8.800"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10014"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215108001722"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196811000-00007"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211100509"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23520"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711600507"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27492"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1087-0024.2000.00014.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7536.285"},{"key":"e_1_2_8_16_1","first-page":"165","volume-title":"Plastic Surgery","author":"Sen CK","year":"2018"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2004.11.002"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:22:51Z","timestamp":1760970171000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,5]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/ohn.570"],"URL":"https:\/\/doi.org\/10.1002\/ohn.570","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2023,11,5]]},"assertion":[{"value":"2023-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}