Q. My wife has hoarseness of voice and a small cyst on the vocal cord. Does it need a biopsy?

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Oct 27, 2020

Hi doctor,

My wife, who is 32 years old, had a problem with hoarseness of voice for a month. As my wife is in the teaching profession, the use of voice is too high. She is also doing online business, which requires taking in the phone continuously. We have consulted an ENT specialist, and the doctor himself did an endoscopy. It shows a small cyst on the right vocal cord. However, the report is not prepared; he has advised restriction of the use of voice. The doctor has recommended for microsurgery, and after surgery, a voice therapy. What is your opinion? Is this kind of cyst is malignant? Should a biopsy be done after surgery?



Welcome to icliniq.com.

A vocal cord cyst is a benign lesion involving the right vocal cords and is responsible for the hoarseness. Usual reasons for developing are overuse of the voice, which causes excessive vibration and microtrauma to the different vocal cords layers, causing a cystic swelling to occur. Any lesion occurring on the vocal cords will obstruct the normal wave pattern and vibratory capacity, causing a voice change.

The usual standard treatment is a micro laryngeal surgery in such a scenario. As a rule, the excised cyst is sent for histopathological examination to ascertain the cyst's nature. In most cases, the lesions are benign, and in such a scenario, nothing has to be done post-surgery. The vocal cords' look and appearance will give a near-to- probable diagnosis of this lesion being benign or malignant. Still, if the term cyst has been used, it usually indicates a benign lesion unless proved otherwise.

Absolutely voice rest and hygiene is the single most pre and post-operative condition and, in my opinion, should go on for at least two long weeks post-surgery. Absolute voice rest means the patient should not be saying yes or no, not whispering (which is more dangerous), and maintaining good vocal hygiene as advised by your operating surgeon. If an excellent complete excision of the lesion has been done, the prognosis is good, and recovery to a normal voice is usually present in most cases.

However, please understand that recurrence is too high if the patient does not follow instructions as given. In most cases, conservative treatment (non-surgical) is not sufficient, and voice remains the same with little or no changes if surgery is not performed.

I hope this answers your query. If there is anything more that you need to know, kindly do let us know, and we will get back to you as soon as possible.

Warm regards.

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