Ward P H, Berci G
Laryngoscope. 1982 Dec;92(12):1377-82. doi: 10.1288/00005537-198212000-00007.
Repeated analysis of cinephotographic and cinefluorographic studies, correlated with clinical observations, have provided insight into the physiopathology of many cases of chronic non-specific pharyngitis, laryngitis, contact ulcers, granulomas, and pachylaryngitis. Hiatal hernia and gastro-esophageal-pharyngeal reflux appear to be the cause of local irritation. Chronic coughing and habitual harsh throat clearing initiate the contact ulcers and granuloma formation. the successful treatment of this entire family of lesions is dependent upon elimination of vocal abuse and control of the factors that are responsible for the chronic irritations.
