Benign non-cancerous growths on the vocal folds are most often caused by inefficient voice use, which causes trauma to the vocal folds. These lesions (or “bumps”) on the vocal folds alter vocal fold vibration and lead to hoarseness.

The most common vocal fold lesions are nodules, polyps, and cysts.

Symptoms of Nodules, Polyps, and Cysts

Patients with nodules, polyps, and cysts may complain of the following:

• Hoarseness
• Effort or strain with speaking
• Breathiness
• Voice breaks
• Vocal fatigue
• Raspy voice

Vocal nodules (also known as nodes or singer’s nodes) are akin to “calluses” of the vocal folds. They occur on both vocal cords opposite each other at the point of maximal contact.

Polyps can occur on one side or both and may be white, translucent, or red if there is a hemorrhage.

Cysts can also vary in color between white and translucent, and depending on its depth within the vocal fold, may significantly impact vocal fold vibration.

Treatment

A specific treatment approach depends on the type and size of lesion and its effect on the voice.

Usually, nodules respond very well to voice therapy, with a noticeable reduction in the size of the nodules and a significant improvement in voice quality and effort is observed.

A patient with a cyst or polyp may find that the voice improves with voice therapy and optimal vocal hygiene, since swelling around the lesions may be reduced. However, microsurgery is frequently needed to maximize vocal quality.

Surgery Considerations

Of course, a decision to undergo vocal surgery is always based on discussions between the otolaryngologist and the patient, and will depend on the patient’s goals.

Surgery for benign lesions typically requires seven days of complete voice rest after surgery, followed by a period of conservative voice use. Pre- and postoperative voice therapy is recommended for all of these patients in order to safely regain vocal function and improve the vocal habits that initially led to the formation of the lesion.

Benign lesions are subject to recurrence if the phonotraumatic events that caused the problem are not resolved.