Benign Vocal Fold Lesions

Benign vocal fold lesions can be growths, trauma or changes to the vocal folds that impact vocal quality and function.

Types of Benign Vocal Fold Lesions

Nodules: One of the most common benign vocal fold lesions. Typically caused by extensive voice demands, repetitive overuse or traumatic injury. Vocal fold nodules are also known as calluses of the vocal fold. These lesions are usually on bilateral and symmetric. Voice therapy is the most common treatment.

Polyps: Similar to nodules, these lesions are typically caused by acute vocal trauma or some form of vocal overuse. They are a fluid-filled lesion composed of gelatinous material that most often occur unilaterally.

Cysts: These are fluid-filled sessile growths that can be present congenitally or be acquired later in life. There are no clear etiological factors. These are less common than vocal cord nodules and polyps.

Granulomas: Also known as a contact ulcer, benign in nature, is an area of inflammation typically located in the back area of the larynx. These lesions are often associated with laryngeal intubation injury following surgery or vocal misuse.

VF Hemorrhage: Typically occurs from traumatic injury to the small blood vessels of the vocal folds. A small blood vessel on the top of the vocal folds breaks that causes bleeding into the layer under the surface lining of the vocal fold.

VF Scar / Sulcus: This occurs when the body attempts to heal itself from an injury to the vocal folds.  The scar tissue that forms is less pliable than normal tissue is; therefore, the vibratory pattern to create the sound of the voice may be altered. Unlike many other benign lesions, scar tissue on the vocal folds are mostly permanent.

Ectasias / Verices: Typically occurs secondary to phonotrauma. They are dilated or abnormal blood vessels and other vascular malformations under the surface of the vocal fold that can bleed and can cause vocal fold stiffness.

Reinke’s Edema: occurs when the layer under the surface lining of the vocal fold, also called Reinke’s space, fills with fluid from long-standing vocal trauma, typically from smoking. The result from Reinke’s edema is typically a low pitch and hoarse vocal quality, or what people refer to as “smoker’s voice.”

Speech-Language Pathology Evaluation & Therapy

Our Speech-Language Pathologists, who have specialty training and expertise in voice disorders, assessment and treatment, will complete a personalized assessment of your voice. Assessment will include:

• A detailed history collection
• Laryngeal Function Studies consisting of computerized voice analysis and airway measures
• Behavioral voice and communication analysis
• Stimuability trials

Prior to the initiation of voice therapy, a laryngeal examination must be completed in order to identify the etiology of your individual voice problem and determine the most appropriate course of treatment.

If you are recommended for voice therapy, your therapy program may include some or all of the following techniques:

• Strengthen and re-balance laryngeal and pharyngeal musculature, including the muscles, joints and ligaments used in voice production
• Learn techniques for producing a healthy voice while eliminating overuse or abuse
• Exercise laryngeal muscles
• Create a healthy motor pattern and balance pressures to achieve the ideal configuration of your vocal folds for voice use
• Learn suppression and breathing strategies to minimize coughing or throat clearing (if this is a problem for you)

Additional Information

American Speech-Language Hearing Association – Voice Disorders: Voice Disorders (asha.org)

American Speech-Language Hearing Association - Vocal Fold Nodules & Polyps: Vocal Cord Nodules and Polyps (asha.org)