Vocal Cord Polyps, Nodules and Cysts
These represent a group of benign (non-cancerous) growths on the vocal cords which are one of the most common reasons for prolonged vocal hoarseness.
Vocal cord nodules
Vocal cord nodules, also known as vocal fold nodules, are benign (non-cancerous) growths that are usually found on the surface of both vocal cords, typically as a result of chronic vocal strain or overuse. They are sometimes referred to as “singer’s nodules” because they are common among individuals who use their voice intensively, such as singers, teachers, actors, and public speakers.
Vocal cord polyps
Vocal cord polyps are benign growths that develop on the surface of one vocal cord, typically resulting from vocal trauma, such as prolonged shouting or singing, or irritation from factors like smoking. Unlike vocal cord nodules, which are usually small and occur in pairs, polyps tend to be larger, can vary in shape, and are often unilateral (affecting only one vocal cord).
Vocal cord cysts
Vocal cord cysts are benign, fluid-filled sacs that form within the vocal cords, typically caused by blockage of a gland or due to vocal strain. There are two types: mucus retention cysts, caused by blocked mucus glands, and epidermoid cysts, which are often congenital or develop from trauma. Vocal cord cysts are typically unilateral (affecting one vocal cord).
What are the best treatments for vocal cord nodules, polyps or cysts?
The best treatment for vocal cord nodules typically involves a combination of voice rest, voice therapy, and lifestyle changes to reduce vocal strain. Voice therapy, guided by a speech-language pathologist, focuses on teaching proper vocal techniques, such as breath support and avoiding unnecessary vocal tension, which helps reduce further irritation to the vocal cords. Additionally, modifying behaviours like reducing shouting, staying hydrated, and avoiding irritants like smoking can aid in recovery. In most cases, vocal cord nodules heal without surgery, but in persistent or severe cases where conservative treatment fails, surgical removal of the nodules may be considered, though this is a last resort.
Vocal polyps and cysts tend to respond less well to voice therapy alone and surgery if often indicated. Surgery involves a general anaesthetic (where you will be asleep) and a metal tube (laryngoscope) is passed through your mouth to get a view of the vocal cords. The polyp or cyst is then carefully dissected free using a microscope and microsurgical instruments. A laser is sometimes used alongside injections of salt water or steroid. This surgery is typically performed as a day case and requires 3-7 days of voice rest afterwards followed by a further week of gentle voice use. Following the surgery, there is sometimes a mild sore throat that can be managed with simple pain relief medication. The voice tends to normalise after two weeks after an excision of a polyp. With cysts, vocal recovery can take longer due to the healing process taking place within the vocal cord. In both cases, pre-operative and post-operative voice therapy are essential to achieve the optimal result.
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