Vocal fold polyps and nodules are often considered to be similar lesions on a spectrum of benign lesions that affect vocal folds. They are generally related to phonotrauma or the collisions of the vocal folds during use, which may be due to regular talking, overuse, or simply vocal abuse. Singers, for example, are often affected by vocal fold nodules due to constant vocal fold use at a high level.
These lesions are often appreciated by patients after a change in vocal quality (e.g. hoarseness, raspiness, etc.) due to disruption of the normal fluid wave that occurs along the vocal fold when making sound. The diagnosis is made by a taking complete history and carefully examining the vocal cords either by flexible laryngoscopy (a flexible camera placed through the nose) or a videostroboscopy (a flexible or rigid exam of the vocal cords which allows for examination of the vocal fold mucosal wave).
Management varies based on the size of the lesion and its effect on the patient’s ability to meet vocal demands. Initial therapy may include referral to a Speech-Language Pathologist for voice therapy, which helps educate patients on more efficient use of their voicebox.If patients cannot meet their demands following voice therapy or the lesions are not appropriate for voice therapy alone, surgery is offered to remove the lesions while preserving the maximal amount of normal vocal fold that results in improved vocal function.