Thursday, December 18, 2014

Vocal Cord Nodules And Polyps

Definition

Vocal cord nodules and polyps are small growths that develop on the vocal cords of some people.

Description

The vocal cords are the folds of mucous membrane in the larynx. The superior pair are called the false, and the inferior pair are the true vocal cords. These thin, reed-like bands vibrate to make vocal sounds during speaking and are capable of producing a vast range of sounds. One end of each cord is attached to the front wall of the larynx. The opposite ends are connected to two tiny cartilages near the back wall of the larynx.

A vocal cord nodule is a small, inflammatory or fibrous growth that develops on the vocal cords of people who constantly strain their voices. These are also called screamer's nodule, singer's nodule and teacher's nodule. A vocal cord polyp is a small swelling in the mucous membranes covering the vocal cords. As they grow, they take on a rounded shape. They may run the whole length of the vocal cords or be localized.

Causes

People who use their voices a great deal, such as professional singers, teachers, auctioneers, lecturers, and members of the clergy, are prone to have nodules on their vocal cords. Like polyps, nodules may develop as a result of excessive use of the voice.

A nodule differs from a polyp in that it is a growth of the epithelium that covers the mucous membrane, not of the mucous membrane itself. Thus, it has a structural resemblance to a corn on a toe or a callus on the hand. If one has vocal cord nodules, the voice will become breathy and hoarse.

Polyps are lesions that develop from voice abuse, chronic laryngeal allergic reactions and chronic inhalation of irritants, such as industrial fumes and cigarette smoke. It may also be seen in hypothyroidism.

Symptoms

Polyps can make the voice become breathy-sounding and harsh. The person may complain of hoarseness.

Diagnosis

It is important to rule out squamous cell carcinoma of the larynx. Your physician may recommend indirect laryngoscopy to visualize the vocal cords.

Treatment

Treatment requires modification of voice habits, and referral to a speech therapist may be indicated. Resting the vocal cords by allowing little or no speaking for several weeks may permit the nodules to shrink. Children occasionally have screamer's voice nodules and these can be treated by voice therapy alone.

Inhaled steroid spray may be helpful. Sometimes biopsy and surgical removal are necessary. They can be removed during the course of a special examination (a laryngoscopy) in which a metal tube with a light on the end is passed through the mouth and into the throat. A small, sharp, cup-shaped punch is threaded through the tube and used to clip off the polyps. Biopsy of the polyp may be performed in order to be certain that there is no cancer. Removal of a polyp should be followed by voice therapy to correct the underlying cause.

Questions

Do any tests need to be done to establish the cause?

How severe is the condition?

What is the prognosis?

What treatment do you recommend?

How effective is this treatment for the condition?

How long will it take for relief of symptoms?

If conservative treatment fails, is surgery necessary?

What can be done to prevent this from recurring?

Do you recommend speech therapy?

Prevention

Good preventive practices include:

  • Properly using the voice to eliminate strain
  • Avoiding screaming and loud talking
  • Speaking in a normal range that is comfortable
  • Not whispering or speaking at a higher or lower pitch than is natural
  • Releasing neck tension by gently tipping the head forward and to each side while keeping the shoulders down.