Vocal Cord Polyp
What is a vocal cord polyp?
A vocal cord polyp is one of the most common disorders affecting the vocal cords. During examination, it can be defined as a mass that is clearly distinguishable from normal tissue. It usually appears on one or both vocal cords, on the inner surface where the vocal cords make contact. It may be white, pink or red in color. It usually occurs in the middle area where the vocal cords vibrate the most.
Vocal cord polyps are benign; when diagnosed correctly, there is theoretically no risk of them developing into malignant diseases (vocal cord cancer). However, polyps can be mistaken for other laryngeal diseases, especially under unfavorable examination conditions or inexperienced evaluations. Therefore, the most reliable diagnosis is always made by pathologic examination.
What are the symptoms of vocal cord polyps?
The most common symptom of vocal cord polyps is hoarseness. This hoarseness can be seen as a rough, muffled, breathy, or variable sound due to irregular vocal cord closure. Since polyps can appear in various shapes and sizes, the intensity and variety of symptoms can also differ. They generally do not cause pain, but after prolonged or strenuous voice use, pain and discomfort around the neck may be felt.
How Does a Vocal Cord Polyp Form?
Vocal cord polyps, like vocal cord nodules, occur after hyperfunctional use of the voice (excessive and incorrect use of the voice). While there is usually ongoing misuse in vocal cord nodules, a vocal cord polyp typically arises after a single voice trauma such as yelling, screaming, or speaking loudly in a noisy environment. After a small polyp forms, the size of the polyp may increase due to repeated voice traumas and irritation of the area where the polyp is located, making the patient's complaints more pronounced or increasing them.
What is the Shape of a Vocal Cord Polyp, What Does it Look Like?
A polyp can be attached to healthy vocal cord tissue by a thin stalk or a broad base. Sometimes it has a millimeter-thin stalk, while in some cases, it can originate from the entire inner surface of the vocal cord. While it usually originates from a single vocal cord, it can also be found on both vocal cords. Its color may frequently be red due to bleeding in the vocal cord (hemorrhagic polyp), but it can also appear pink, white, or even purple. Some polyps may look white, gray, or glassy. These polyps are also called hyaline polyps.
How is a Vocal Cord Polyp Diagnosed?
The diagnosis of a vocal cord polyp is made by visualizing the vocal cords and larynx (throat) in office conditions with appropriate instruments. The name of the procedure depends on the instrument used and is called rigid endoscopic laryngeal examination (videolaryngostroboscopy) or flexible fiberoptic laryngoscopy. Examination under stroboscopic light provides more information for us. Thanks to advanced instruments, this examination can be performed using both rigid and flexible endoscopes today. With stroboscopic examination, it is observed that the closure of the vocal cords is affected in a manner that will change depending on the size and location of the polyp. Stalked polyps can move up or down on the vocal cords during examination.
How is a Vocal Cord Polyp Treated?
As with all voice disorders, there are three main methods for treating vocal cord polyps. These methods are:
- Behavioral methods: Voice Therapy
- Medical methods: Medication Treatment
- Surgical methods: Microscopic surgery of vocal cords (Phonemic surgery) (Voice Surgery)
Vocal rest, vocal hygiene and other vocal therapy approaches are very important in the treatment of vocal cord polyps, especially after vocal cord polyp surgery to prevent recurrence. The more the wrong vocal behavior that leads to vocal cord polyps is abandoned, the easier it will be to prevent the recurrence of vocal cord polyps.
Medication is an approach that can be useful in managing conditions that predispose to polyp formation (such as allergies, infections, reflux).
Voice Surgery in the Treatment of Vocal Cord Polyps
Phonemic surgery (voice surgery) is the most effective treatment for vocal cord polyps and provides results in the shortest possible time. The main goal during surgery is to remove the diseased tissue while completely preserving healthy and strong vocal cord tissue. Preserving the vocal cord epithelium and the superficial lamina propria layer, which is invaluable for voice quality, improves postoperative results. An appropriate combination of voice therapy and medical treatment after surgery improves surgical effectiveness.
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