The granulomas are usually found near the back portion of the vocal folds over the vocal process of the arytenoid cartilages at the site of contact during vocal fold closure. They often appear pale or sometimes red.
NOTE THAT :Surgery should only be used to treat granulomas that do not respond to first-line treatments of the cause"which may be endotracheal intubation trauma/excessive voice use/Backflow of acidic stomach fluids", or if underlying laryngeal cancer is also suspected.
The photo below shows Vocal Fold With Granuloma and Reflux Laryngitis:
A granuloma (gr) is detected as a yellowish growth covering the right arytenoid process. Irritation from reflux of stomach fluids into the voice box is also detected with redness and swelling in vocal folds (vf) and false vocal folds (f vf) and pachyderma or thickening of tissue in the back of vocal folds