A patient with hoarseness of voice was found to be having pachydermia laryngitis. All of the following are true except:

The most common site for contact ulcers is vocal processes of the arytenoid cailage. Contact ulcers: / Vocal process granuloma / arytenoids granuloma / intubation granuloma. Nearly exclusively seen in men over the age of 30 years. Commonly located over the posterior pa of vocal processes of arytenoid cailage. Can be unilateral or bilateral It is multifactorial in aetiology: - Vocal abuse (most impoant Etiological factor) talking in a habitually low pitched cracky, hyperfunctional manner - Prolonged intubation - Esophageal dysfunction (such as gastroesophageal reflux, hiatus hernia, dysmotility). Symptoms - Low pitch quality of voice (most prominent feature). - Irritation and pain in larynx which worsens on phonation or coughing and it can radiate to ear. Management - Voice therapy along with anti reflux medications. - In persistant cases microlaryngeal excision may be required to confirm the diagnosis and exclude malignancy.