Polyp nodules or cysts on the vocal cords

Diagnosis and Treatment of Vocal Cord Nodules, Polyps, and Cysts

Nodules, polyps, and cysts are benign lesions that affect the vocal cords, causing hoarseness, vocal fatigue, and difficulty projecting the voice. Their diagnosis and management require a specialized approach to avoid complications and restore vocal function.

Advanced Diagnosis

1. Clinical Evaluation

Detailed medical history: Excessive use of the voice, habits such as smoking, gastroesophageal reflux disease (GERD), allergies, or recurrent infections.

Physical Examination: Identification of symptoms such as a breathy voice, roughness, or effort when speaking.

2. Videolaryngostroboscopy (Gold Standard)

Key technique for visualizing the vocal cords in high definition and assessing their vibration.

Allows differentiation between:

Nodules: Symmetrical and bilateral thickenings (like "calluses" on the vocal cords).

Polyps: Gelatinous or vascular masses, usually unilateral.

Cysts: Fluid-filled sacs within the vocal cord tissue.

3. Additional Studies (in selected cases)

Biopsy (if an atypical lesion is suspected).

Acoustic voice analysis (to measure frequency, intensity, and vocal quality).

Personalized Treatment

1. Conservative Treatment (First Line)

✅ Vocal rest (avoid shouting, singing, or excessive talking).

✅ Voice therapy with speech therapy: Exercises to correct poor vocal habits and improve vocal technique.

✅ Medical Management:

Anti-inflammatories (in acute cases).

Reflux control (with proton pump inhibitors if GERD is present).

Hydration and humidification (avoid dry environments).

2. Phonosurgery (When Conservative Measures Fail)

Minimally invasive procedure under a surgical microscope or CO₂ laser, with general anesthesia.

Techniques According to the Type of Lesion:

Vocal Nodules:

Generally improve with vocal therapy.

If they persist, microsurgery is performed to remodel the tissue.

Vocal Polyps:

Precise surgical resection (avoiding damage to the free edge of the vocal cord).

In some cases, a CO₂ laser is used to reduce bleeding.

Intracordal Cysts:

Require careful dissection to remove the cyst without affecting the vibratory layer.

Microflap techniques to preserve vocal function.

3. Postoperative Recovery

Absolute vocal rest for 3-7 days (then progressive rehabilitation).

Phoniatric rehabilitation (4-8 weeks) to prevent recurrence.

Video laryngostroboscopy to verify healing.

⚠️ When to Operate?

If hoarseness persists for more than 3 months despite conservative treatment.

If there is difficulty breathing (large polyps).

In voice professionals who do not improve with therapy.

🌟 Prevention and Care

Avoid overusing your voice (shouting, whispering, throat clearing).

Constant hydration (2 L of water/day).

Control reflux and allergies.

Vocal training (if you use your voice a lot).