Worse With Increase in Size
Patient voice complaints (symptoms) typically worsen over time as a
granuloma grows in size and has a greater effect on vocal fold closure
(breathiness) and vibration (hoarseness).
"Slow Paced" Time Course Usual
Worsening
of voice complaints is typically gradual or "slow-paced." Often
patients are unaware of the problem until someone else notices the
change.