Vocal Cord Skari

Vocal cord scarring is a clinical condition caused by damage to the epithelial and lamina propria layers of the vocal cords.  For the vocal cords to function effectively, they must have a solid multi-layered structure, with the mucosal layers resting on muscle tissue and vibrating harmoniously in both vocal cords.

How does vocal cord scarring occur?

Vocal cord scarring is caused by damage to the vibrating mucosal layers, especially the superficial tissue known as the lamina propria. Damage to this flexible, soft tissue causes the superficial epithelial layer to adhere to the underlying hard muscle layer and the vocal cord loses its flexibility. The size of the inflexible hard scar tissue can vary depending on the cause.

The most important cause of vocal cord scarring is surgery. The most common surgical procedure causing scarring is microlaryngoscopy for benign and malignant diseases of the vocal cords. Intubation-related damage or blunt or sharp trauma to the larynx during other surgeries can also cause scarring. During treatment of benign voice disorders, the surgeon's careful behavior can largely prevent scarring. However, scarring after treatment of vocal cord cancers is inevitable and an expected outcome.

What can be done to prevent vocal cord injury?

After surgeries for benign voice disorders, not using the voice for an appropriate period of time, applying treatments for laryngopharyngeal reflux, quitting smoking and alcohol use after surgery are appropriate measures to minimize the risk of scarring.

What are the symptoms of scarring?

The most common complaint of individuals with vocal cord scarring is hoarseness.  Hoarseness may become more pronounced as the duration of voice use increases. Generally, the larger the scar, the more severe the voice problem becomes.

How is it diagnosed?

The diagnosis of vocal cord scarring is made during endoscopic examination of the vocal cords under a special light technique called videolaryngostroboscopy in office conditions where vibrational movements on the inner surface of the vocal cords cannot be monitored.

How is vocal cord scarring treated?

There is no single method that is useful in treating vocal cord scarring in every patient. Therefore, it is very important to prevent the formation of vocal cord scars. The treatment method for an existing scar is microscopic surgery of the vocal cords under general anesthesia. This technique is known as microlaryngoscopy. When surgically treating the scar, the use of pre- and post-operative medical treatments and voice therapy ensures a better outcome.