Vocal Fold (Cord) Lesions

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What are Vocal Fold Lesions?

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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 fold lesions are one of the most common causes of voice problems.  Types of vocal fold lesions include polyps, cysts, and nodules.

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A change in voice quality and persistent hoarseness are often the first warning signs of a vocal cord lesion. Other symptoms include voice breaks while speaking, vocal fatigue, hoarseness, frequent throat clearing, and airy or breathy voice.  When a vocal cord lesion is present, symptoms may increase or decrease in degree, but will persist and will not go away on their own.

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The exact cause of benign vocal cord lesions is unknown. 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.

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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 often recorded on video. The stroboscopic light source allows your doctor to assess vocal fold vibration.

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Sometimes a second exam will follow after a period of voice rest to allow your doctor an opportunity to assess changes in the lesion. 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 to diagnosis.

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How are Vocal Fold Lesions Treated?

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The most common treatments for vocal cord lesions are voice therapy, vocal rest, and phonomicrosurgery. Phonomicrosurgery is a type of surgery involving the use of microsurgical techniques and instruments to treat abnormalities on the vocal cord.

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Treatment options vary according to the degree of your voice limitation and your vocal needs. For example, if you are a professional singer with benign vocal cord lesions, voice therapy will improve your speaking voice but not your singing voice. You may need surgery to restore your singing voice.

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