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Vocal Cord Lesions

 

Vocal Cord Lesions

The term vocal cord lesion, or vocal fold lesion, refers to a group of noncancerous (benign), abnormal growths (lesions) within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems.

Westside Head & Neck provides comprehensive treatment and services for all types of vocal cord lesions at all stages.

 

Types of vocal cord lesions

  • Vocal cord nodules (singer’s nodes) : Vocal cord nodules are also known as calluses of the vocal fold. They appear on both sides of the vocal cords and directly face each other. Like other calluses, these lesions often diminish or disappear when overuse or misuse of t he voice is corrected.  This problem rarely requires surgical intervention.
  • Vocal cord polyp : A vocal cord polyp typically occurs only on one side of the vocal cord and can occur in a variety of shapes and sizes. Depending upon the nature of the polyp, it can cause a wide range of voice disturbances.  A short surgery is usually necessary to treat polyps.
  • Vocal cord cyst: A vocal cord cyst is a firm mass of tissue contained within a membrane (sac). The cyst can be located near the surface of the vocal cord or deeper, near the ligament of the vocal cord. As with vocal cord polyps and nodules, the size and location of vocal cord cysts determinethe degree of disruption of vocal cord vibration and subsequently the severity of hoarseness or other voice problem s . Surgery followed by voice therapy is the most commonly recommended treatment for vocal cord cysts that significantly alter and/or limit voice.
  • Reactive vocal cord lesion : A reactive vocal cord lesion is a mass located opposite an existing vocal cord lesion, such as a vocal cord cyst or polyp. This type of lesion is thought to develop from trauma or repeated injury caused by the lesion on the opposite vocal cord. A reactive vocal cord lesion will usually decrease or disappear with treatment of the initial problematic lesion, along with voice rest and therapy.

 

Symptoms of vocal cord lesions

A change in voice quality and persistent hoarseness are often the first warning signs of a vocal cord lesion. Other symptoms include:

  • Vocal fatigue
  • Unreliable voice
  • Delayed voice initiation
  • Low, gravelly voice
  • Low pitch
  • Voice breaks in first passages of sentences
  • Airy or breathy voice
  • Trouble with singing range and quality
  • Increased effort needed to speak or sing
  • Hoarse and/or rough voice quality
  • Frequent throat clearing

 

When a vocal cord lesion is present, symptoms may wax and wane, but they will persist to some degree and will not go away on their own.

 

Detection and diagnosis

Vocal fold lesions are thought to arise following heavy or traumatic use of the voice, including voice misuse such as speaking in an improper pitch, speaking excessively, screaming or yelling, or using the voice excessively while sick.

Diagnosis begins with a complete history of your voice problem and an evaluation of your speaking method. Your doctor will carefully examine your vocal cords, typically using rigid laryngoscopy with a stroboscopic light source. In this procedure, a telescope-tube is passed through your mouth to allow your doctor to see your voice box. Images are usually recorded on video. The stroboscopic light source allows your doctor to assess vocal fold vibration.  This exam is not painful and it is quick.  It is performed in a normal office visit without any sedation.

Sometimes a second exam will follow after a period of voice rest to allow your doctor an opportunity to assess changes in the lesion(s) . Other associated medical problems can contribute to voice problems, such as: reflux, allergies, medication side effects, and hormonal imbalances. Evaluation of these conditions is important for proper diagnosis and care .

 

Treatment of benign vocal cord lesions

Treatment options vary according to the degree of your voice limitation and your vocal needs. The most common treatments for vocal cord lesions are:

  • Voice therapy
  • Voice rest
  • Laryngeal microsurgery: a type of surgery involving the use of microsurgical techniques and instruments to treat abnormalities on the vocal cord