The vocal cords are two thin and flexible bands of muscle tissue which run from front to back inside the larynx, just above the opening of the trachea. Lesions of the vocal cords are one of the most common causes of voice disorders.
Vocal cord lesions are benign, abnormal growths that are generally categorized into three types: nodules, polyps and cysts. These lesions are more common in those who use their voice as part of their occupation, such as salesmen, cheerleaders or singers.
Vocal cord lesions can arise as a result of the voice being used too aggressively or too much. Screaming, shouting or trying to talk when one is hoarse, for example, are all factors that may contribute to the problem. Smoking, alcohol use, and allergies may worsen the condition.
Types of vocal cord lesion
Vocal cord nodules
Also referred to as Screamer’s Nodes or Singer’s Nodes, these nodules typically develop on both sides of the vocal folds, usually at the midpoint. Under a microscope, these growths resemble calluses. They are sometimes associated with abnormal vasculature. They are thought to be caused by overuse or misuse of the voice and tend to disappear once this trigger is removed. Both men and women may develop these growths, although they are more common in women in the age group between 20 and 50 years.
Vocal cord polyps
A vocal cord polyp usually appears on only one vocal cord, although in some patients they can develop on both cords. They occur in different shapes and sizes, but tend to be larger than nodules. They look a bit like blisters. Their effects on the voice are wide-ranging, depending on the type of polyp. Compared to nodules, polyps tend to have more blood vessels and are therefore a reddish color. Polyps are also caused by overuse or misuse of the voice such as singing, screaming, shouting or excessive talking. A different type of vocal cord polyp called Reinke’s edema or polypoid corditis is caused almost entirely by smoking.
Vocal cord cysts
A vocal cord cyst is a firm mass of tissue, contained within a membrane, and it may be located near the surface of a vocal cord or deeper, close to the vocal cord ligament. The extent to which it affects the voice depends on the size and location of the polyp. These cysts are less common than the nodules or polyps described above. These cysts are categorized into two types: epidermoid cysts and mucus retention cysts. They may be caused by strained use of the voice, for example, trying to converse as normal during a bout of laryngitis or an infection of the upper respiratory tract. Usually, surgery and voice therapy is recommended for cases where the cyst is causing significant voice disruption.
Symptoms of vocal cord lesions
Most vocal cord lesions manifest as:
- Vocal fatigue
- Raspy voice
- Loss of pitch
- Unpredictable breaking of the voice
- Frequent need to clear the throat
Reviewed by Dr Liji Thomas, MD.