Vocal Cord Nodules and Polyps

Vocal Cord Lesions: Nodules and Polyps

Vocal cord lesions are growths on the vocal cords. They can occur because of a virus, illness, poor vocal technique or poor vocal hygiene. The most common symptom of any vocal cord problem is hoarseness. Growths can also cause pain, coughing, chronic irritation and bleeding.  The vocal cords can be examined in an office with an endoscope.

Polyps and nodules are common vocal cord lesions and tend to appear in people who use their voice extensively, like singers, teachers and public speakers. Learn more about these conditions and treatment options at Northwest ENT and Allergy Center.

Vocal Cord Nodule Symptoms

• Vocal fatigue
• Hoarseness
• Breathiness
• Painful speaking
• Voice breaks
• Increased effort required to produce voice
• Reduced vocal range for singers

Hoarseness or breathiness that lasts for more than two weeks may indicate a voice disorder and should be evaluated by appointment with an otolaryngologist.

Vocal Cord Nodule Causes

Certain professions that require extensive voice use, such as teachers, singers, actors, and public speakers, are at higher risk of developing vocal cord nodules. Nodules are caused by strenuous or abusive voice practices, such as repetitive yelling, coughing, singing and talking loudly.

Other factors can contribute to developing vocal cord nodules or making them worse. This includes smoking, allergies, chronic sinusitis, chronic acid reflux (GERD), hypothyroidism and dehydration which can be worsened by inadequate fluid intake (like too much alcohol and caffeine).

Vocal Cord Nodule Treatment

Although vocal cord nodules alter a patient's voice, they are not malignant and do not result in negative health consequences. Treatment consists of:

• Vocal rehabilitation: you will start with vocal rest first. Then, you will work with a speech-language pathologist (SLP) to learn how to use your voice without causing injury
• Vocal hygiene: you will be given instructions on good vocal hygiene. This includes increased water intake, decreasing caffeine, and, sometimes, anti-reflux medicine.

If the nodules are too large, or if regular treatment does not work, surgery may be required and consultation with your surgeon is recommended. 

What Is a Polyp on a Vocal Cord?

Polyps appear as a swelling or bump, a stalk-like growth, or a blister-like lesion. Like nodules, polyps result from trauma caused by repetitive overuse; however, polyps can also arise from a single episode of vocal cord hemorrhage. Vocal cord polyps are more vascular and can occur on either one or both vocal cords. Polyps also vary in size and are often larger than nodules.

Vocal Cord Polyp Symptoms

The symptoms of vocal cord polyps can be similar to those of nodules (vocal fatigue, hoarseness, breathiness, etc)  but may be more pronounced or develop more rapidly. The severity of symptoms can vary depending on the size, location, and number of polyps present.

Vocal Cord Polyp Causes

Like vocal cord nodules, vocal cord polyps develop because of vocal trauma or voice misuse. They are also associated with other factors, like smoking, allergies, too much alcohol, too much caffeine, chronic sinusitis, hypothyroidism and GERD. 

Vocal Cord Polyp Treatment

If the polyp is small, your doctor might recommend voice rest, followed by voice therapy and lifestyle modifications (similar to how nodules are treated). If the polyp is large, surgery may be required. ENT doctors perform this procedure.

Vocal Cord Polyp and Vocal Cord Nodule Surgery

At Northwest ENT, removal of vocal cord polyps or nodules is performed through direct laryngoscopy or microlaryngoscopy. The surgery requires no incision. Patients are placed under general anaesthesia and can typically go home on the same day.

Direct laryngoscopy is done using a laryngoscope, which is a small examining tube that allows your ENT to look directly at your vocal cords and throat. During a microlaryngoscopy, the ENT uses a microscope instead to visualize the polyp or nodule they will remove. They then use special tools to remove the growth.

After your surgery, voice rest is usually recommended for 24 to 48 hours. Recovery is quick with minimal to no pain. In many cases, voice therapy is recommended to avoid future lesions. Out of town patients are cleared for travel the next day.

How To Diagnose Vocal Cord Nodules And Polyps

If your doctor suspects that you have polyps or nodules, they will usually perform two different tests.

The first test is a flexible laryngoscopy. It involves inserting a flexible scope into your throat (or nose) to look at your voice box and detect whether nodules or polyps are present. 

The other test is called a videostroboscopy. For this test, a similar flexible scope with a small camera is used to visualize the throat and vocal cords. Normally, the vocal cords vibrate too rapidly for the human eye to notice how they move. During a stroboscopy, the camera records a video of how the cords vibrate. Your doctor or healthcare provider can then watch this video in slow motion and see whether the cords are vibrating as they should.

The procedure also shows how a polyp, nodule or other condition affects the way the cords vibrate. It can also help detect more subtle lesions of the vocal cords and is the preferred study in cases of hoarseness.

Find Treatment For Vocal Cord Nodules And Polyps At Northwest ENT

If you’re experiencing persistent voice pain or changes, it may be time to consult an ENT specialist. At Northwest ENT, we can diagnose, treat and help you prevent injury to your vocal cords. Schedule an appointment at any of our six locations in the Metro Atlanta area to speak to a specialist about your concerns.