 Later, the same condition was observed in patients recovering from recent intubation and, more recently, came to be associated with inflammation and irritation resulting from gastro-esophageal reflux.Likewise, use of both "ulcer" and "granuloma" reflect the fact that this condition can present as an ulcerated lesion or as granulated tissue.In medical literature today, the term "vocal process granuloma" is preferred over the term "contact ulcer" or "contact granuloma;" this reflects the fact that this condition can result from a variety of different causes and not just excessively forceful contact of the vocal folds as was originally believed.