GRANULOMAS and ULCERS occur most commonly in male public speakers, teachers, sales representatives, politicians and actors.contact ulcers can result from grinding , hammering action of vocal process of the Aryteniod cartilages. these occur during repeated use of loud , low pitched , pseudo authoritative voice .Granulomas is characterized by a low pitch and huskiness. other factor associated with the development of contact ulcer involves cigarette smoking , excessive alcohol and caffeine consumption and reflux of stomach acids.
