What Are Vocal Fold Polyps, Cysts, and Nodules?
Vocal Fold Polyps: These can appear on one or both sides of the vocal cords are vascularized (have blood vessels), and appear reddish. The vocal fold polyps look like blisters and can be in varying shapes and sizes. These polyps mainly occur due to overuse and misuse of the voice, especially due to sudden yelling or vocal abuse. Vocal fold polyps cause various traumas, such as screaming, singing, excessive talking, and cheerleading.
In addition, these voice problems may occur due to extra muscle tension while smoking, speaking, allergies, alcohol use, and sinusitis. Reinke’s edema or polypoid corditis is a type of vocal cord polyp usually appearing due to smoking and sometimes with hypothyroidism.
Vocal Fold Cysts: These are vocal cord lesions with a semisolid center or a fluid-filled sac around them. Vocal fold cysts are rare and mainly are of two types, sebaceous or epidermoid cysts, and mucus retention cysts. These lesions do not occur due to overuse or misuse of the voice, like vocal cord polyps and nodules.
Vocal Fold Nodules: These are caused due to the repetitive and frequent overuse and misuse of the voice, thus causing vocal cord trauma. These nodules in the vocal cord are often called nodes or singer’s nodules. Vocal fold nodules are callous-like growths in the center of the vocal folds. They are sometimes associated with abnormal blood vessels as they appear callous-like under the microscope. Vocal fold nodules can affect both males and females, but women are more prone to develop this condition between the age of 20 to 50 years.
What Are the Causes of Vocal Fold Polyps, Cysts, and Nodules?
Vocal fold cysts, polyps, and nodules are mainly caused due to frequent trauma to the vocal folds due to constant taking, yelling, screaming, and misuse of the voice. Nodules and polyps in the vocal folds can occur due to irritants in the cigarette and stomach acid reflux into the larynx. On the other hand, vocal fold cysts usually appear due to mucus gland blockage under the tumors of the vocal cords and thus cause voice problems. These vocal cord tumors mainly occur due to alcohol abuse and smoking.
What Are the Symptoms of Vocal Fold Polyps, Cysts, and Nodules?
The symptoms of vocal cord lesions include:
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Hoarse voice.
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Breathy or airy voice.
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Frequent throat clearing.
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Vocal fatigue.
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Difficulty in singing high-pitched notes.
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Low-pitched voice.
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Increased efforts to sing or speak.
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Shooting ear-to-ear pain.
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Coughing.
Who Is at a Risk of Developing Vocal Cord Problems?
Vocal cord problems usually appear in people to speak a lot or overuse their voice. Nodules usually appear in these people. They include
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Radio hosts.
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Singers.
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Cheerleaders.
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Teachers.
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Preachers.
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Salesperson.
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Coaches.
How Are Vocal Fold Polyps, Cysts, and Nodules Diagnosed?
A person experiencing the symptoms of vocal cord lesions, such as voice hoarseness that may persist for more than one or two weeks, should consult the ENT (ear, nose, and throat doctor), also known as an otolaryngologist, for an initial examination and diagnosis. In addition, a laryngologist's exact diagnosis of the vocal cord defect is made with the help of a laryngoscopy using a stroboscope or video stroboscope. This is a special light to examine the vibrations of the vocal cord. The doctor also examines the head and neck of the patient and thus evaluates the case. Depending on the patient's initial examination, he may suggest further testing for voice (acoustic) analysis.
What Is the Management of Vocal Fold Polyps, Cysts, and Nodules?
Diagnosing vocal fold polyps, cysts, and nodules is crucial in managing vocal cord lesions. Various treatment options are available to manage these conditions, including conservative behavioral, dietary, medical, and surgical interventions. The doctor mainly advises behavioral voice therapy for vocal cord nodules, and surgical interventions are recommended if the refractory lesions are present and voice therapy alone is not very effective. On the other hand, vocal cord lesions like cysts and polyps cannot be managed with voice therapy, and therefore the surgical approach is needed in such cases.
The treatment of vocal fold polyps, cysts, and nodules include
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Voice Therapy: This treatment method heals the vocal cord injury and helps prevent future trauma. Voice therapy is conducted by a professional speech pathologist who engages people in various vocal exercises to reduce throat strain, improve breathing, and obtain maximum frequency, pitch, and resonance for healthy and strong speaking. Voice therapy plays an important role in the voice recovery of the patient to improve voice quality.
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Vocal Cord Laser Surgery: Some vocal cord lesions need to be removed. The doctor uses a thin scope to perform the procedure under general anesthesia. This device is inserted in the patient’s nose to shrink the vocal cord lesion with laser beams. After the procedure, the patient is advised to take voice therapy and voice rest.
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Microsurgery: These surgeries are recommended for various non-cancerous lesions of the vocal cord, such as polyps, cysts, and nodules. The procedure is also known as phonomicrosurgery. The surgeon inserts the small surgical instrument in the patient's throat via mouth under general anesthesia. The lesion growth is removed by making a small incision away from the vibrating edge of the vocal cord by raising a thin flap of non-cancerous tissue growth. This surgical method minimizes the risk of scarring and provides the best voice quality. For optimal recovery, the doctor recommends voice therapy after microsurgery.
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Medical Management: Various medical problems causing voice disorders, such as acid reflux, chronic cough, and allergies, are also treated with medications.
How to Prevent Vocal Cord Lesions?
Vocal cord lesions can be prevented in the following ways:
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Avoiding smoking and alcohol.
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Getting proper treatment for allergies, sinusitis, hypothyroidism, or acid reflux.
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Warming up the voice before prolonged speaking and singing.
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Reduce muscle tension by indulging in yoga, relaxation techniques, and cognitive therapy.
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A person should refrain from excessive and frequent taking without adequate voice rest.
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A person should use a microphone.
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Drinking plenty of water and avoiding excess caffeine intake.
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Avoid excessive talking and slinging if a person has an upper respiratory infection.
Conclusion
Vocal fold lesions are mainly associated with vocal trauma and voice overuse in people who talk excessively while taking voice rest. The condition can also occur due to various underlying medical conditions like sinusitis, allergies, etc. Therefore, a comprehensive treatment is used to manage vocal fold polyps, cysts, and nodules. Though these lesions are non-cancerous, they may impair speech and affect a person's breathing if left untreated. In some cases, larynx cancer may also develop in the vocal cords due to changes in voice and hoarseness. Therefore, a person experiencing any symptoms of vocal fold lesions (cysts, polyps, and nodules) should immediately consult the doctor for early diagnosis and treatment.
