Vocal cord lesion

Vocal cord lesions are growths on the vocal cords, the muscles and tissue that line your voice box (larynx) and allow you to make vocal sound like speaking or singing. They can be caused by poor vocal technique or hygiene, or a virus or illness.

• Vocal cord cysts, nodules, and polyps: non-cancerous growths or bumps (similar to calluses on the hand) that are most common among people who spend a lot of time speaking or singing, such as teachers or vocalists.
• Vocal papillomas: small, wart-like growths caused by the Human Papilloma Virus (HPV). These can impair speech and if left untreated, may affect breathing.
• Larynx cancer: one of the most common types of head and neck cancers that causes hoarseness or changes in the voice if it forms on the vocal cords. This allows it to be found at an earlier stage than if it forms in other parts of the larynx.

A person with a vocal cord lesion may experience:

• Chronic hoarseness for more than two weeks (such as a raspy or breathy voice, a voice quiver, or a strained or choppy voice)
• Pain or a lump in the throat when speaking
• Changes in pitch
• Odd sounding speech

When diagnosing vocal cord lesions, like vocal nodules, cysts, and polyps, physicians specializing in voice and speech disorders at the Penn Center for Voice, Speech and Swallowing will review your medical history and perform a clinical exam.

A diagnostic tool called video stroboscopy will be used to determine the type and severity of your lesion. Video stroboscopy is a painless, outpatient procedure that uses a synchronized, flashing light to visualize vocal cord vibration. During this exam, a flexible tube (nasopharyngoscopy) equipped with a strobe light and camera is passed through your nose and positioned just above the vocal cords. Alternatively, a rigid telescope can be passed through your mouth — over the tongue — to visualize vocal cords. This light flashes on and off as your vocal cords vibrate. A microphone is placed along your neck to simultaneously detect the frequency of the vocal cords.

If your lesion is the result of poor vocal technique or hygiene, your otolaryngologist at the Penn Center for Voice, Speech and Swallowing will refer you for speech modulation therapy. This treatment is focused on improving breathing, voice projection, and vocal hygiene techniques.

If you are diagnosed with a cyst, nodule, or polyp, your otolaryngologist may remove it using a phonosurgical approach, which can include injections, minimally invasive surgery, or open surgery. Laser techniques, or a combination of the two treatment approaches can also be used.

If you are diagnosed with papilloma or larynx cancer, your otolaryngologist will surgically remove the growth in coordination with specialists from Penn Medicine’s Center for Head and Neck Cancer. This is done with minimally invasive approaches that are often conducted in an outpatient setting and result in reduced recovery times and risk of infection. After this procedure, you will be required to rest your voice for several days. Never whisper or shout after vocal surgery. Pain is usually controlled with Tylenol or ibuprofen. Voice therapy can begin a few weeks after surgery to allow for proper healing to occur. In some cases, the removal of the lesion will improve vocal quality immediately.