I had 3 operations in the first 5 years without success (it just came back) but a breakthrough came 4 years ago when my ENT specialist put me on
lansoprazole, a PPI, believing that it was probably due to acid reflux (although I had no symptoms). The granuloma disappeared over the next 6 months.
However, it sometimes comes back, or at least the symptoms do, every few months, but go again after 2 or 3 weeks. But over the last week or so symptoms have come back with a vengeance.