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Sunday, September 4, 2011

A Family Doctor's Tale - VOCAL CORD POLYP

DOC I HAVE VOCAL CORD POLYP, NODULE AND CYST

Vocal polyp is a benign tumor with soft round body rising on a stalk from one of the vocal cords.

Vocal nodules are thickened area occurring on both vocal cords
and are also known as singer's nodules or callusese of the vocal cords.

Vocal cysts are swellings (containing fluid in a sac) found on the vocal cords.  

Vocal polyp,nodules and cysts can occur at any age.

The causes of vocal polyp and nodules are:

1.Vocal polyps and nodules are usually the result of chronic inflammation or repetitive trauma to the vocal cords such as frequent shouting or voice overuse.

2.reflux of acid from stomach to larynx

3.smoking irritates the vocal cors

4.cysts occur due to blockage of a mucous gland in the mucosa of  the vocal cords.

Symptoms of Vocal Cord Polyp, Nodule and Cyst:
1.Hoarse voice

2.breathless voice

3.low pitch husky voice

4.vocal faigue

5.inability to sing high pitched notes

6.increased effort to speak or sing

7.frequent throat clearing

Diagnosis of Vocal Cord Polyp, Nodule and Cyst:
1.history of voice problem

2.nasoendoscopy through the nose down to vocal cord under local anesthesia to check on the vocal cords and confirm the presence of nodules, polyp or cysts

3.test for laryngopharyngeal reflux

4.Sensitive nose and sinusitis may be excluded with CT Scan of skull from nose to vocal box.

There can be complications of Vocal Cord Polyp, Nodule and Cyst such as:
1. bleeding (rare)

2. chronic hoarseness of voice

Treatment of Vocal Cord Polyp, Nodule and Cyst:
Medical:
1.antibiotics to treat infections

2.antihistamine to treat allergy

3.antacid to reduce acid reflux

4.voice rest

Most benign vocal cord growths will resolve with conservative medical treatment especially voice rest.

Surgery:
The only surgical treatment is phono-microsurgical removal of the Vocal polyp,nodules and cysts if the medications do not work or if there is suspicion of cancer.

Phono-microsurgery is surgery to the vocal cord using micro-surgical techniques and instruments and sometimes lasers.

This surgery can also be done to improve the voice or remove a growth for microscopic analysis.

If a lesion is found to be cancerous, further treatment may be required.

The prognosis of a Vocal Cord Polyp, Nodule and Cyst is usually excellent.

Recurrence at the same spot is rare but do occur due to regrowth of the blood vessel supplying the Polyp or nodule.

Prevention of Vocal Cord Polyp, Nodule and Cyst:
Avoid strenuous use of the vocal cords

Avoid smoking and alcohol

Avoid any irritants or allergies as much as possible

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