Vocal Cord Nodules and Polyps

Vocal Cord Nodules and Polyps

 

Definition

Vocal cord nodules and polyps are noncancerous growths on the vocal cords that affect the voice.

Description

The vocal cords, located in the voice box in the middle of the neck, are two tough, fibrous bands that vibrate to produce sound. They are covered with a layer of tissue that is similar to skin. With use, this layer thickens. With heavy use, the thickening may localize, producing a nodule. Unlike skin, heavy usage over a short time may also produce polyps. A polyp is a soft, smooth lump containing mostly blood and blood vessels. A nodule is similar to a polyp, but tends to be firmer.

Causes and symptoms

Chronic infections caused by allergies and inhalation of irritants, such as cigarette smoke, may produce these lesions, but extensive use of the voice is the most common cause of vocal nodules and polyps. Nodules and polyps are more common in male children, female adolescents, and female adults. This may be due in part to the faster speed at which the cords vibrate to produce higher-pitched voices.
Voice alterations are most apparent in singers, who may notice the higher registers are the first to change. Hoarseness causes others to seek medical attention.

Diagnosis

The head and neck surgeon (otorhinolaryngologist) must see the vocal cords to diagnose these lesions. It is also important to confirm that there are not other problems instead of or in addition to these benign lumps. Other causes of hoarseness include throat cancers, vocal cord paralysis, and simple laryngitis. The cords can usually be seen using a mirror placed at the back of the tongue. More elaborate scopes, including a videostroboscope, allow better views while the cords are producing sounds.
A biopsy of a nodule or polyp will ensure they are not cancerous.

Treatment

Nodules usually only require voice therapy; less than 5% of nodules require surgery. Small polyps can be treated with voice therapy, but typically they are surgically removed.

Prognosis

Continued overuse of the voice will cause these lesions to regrow.

Prevention

Careful use of the voice will prevent most vocal cord nodules and polyps. Avoiding inhaled irritants, may also prevent nodules and polyps from forming.

Resources

Books

Ballenger, John Jacob. Disorders of the Nose, Throat, Ear, Head, and Neck. Philadelphia: Lea & Febiger, 1991.

Key terms

Laryngitis — Inflammation of the larynx (voice box).
Lesion — A wound or injury.
Otorhinolaryngologist — A physician specializing in ear, nose, and throat diseases. Also known as otolaryngologist.