Treatment for benign (non-cancerous) lesions of the vocal folds, such as nodules, polyps, or cysts, can involve a combination of voice therapy and surgery. Usually vocal nodules will resolve with voice therapy alone.

For patients with a polyp or cyst, voice therapy can help achieve more healthy voice production, and in some cases, this may meet the patient’s voice goals. However, with a vocal fold polyp or cyst, surgery is often recommended for the best voice outcome, depending upon the patient’s needs. Polyps and cysts of the vocal cords can result in a hoarse voice that does not respond to speech therapy.

Microsurgery is used to remove these lesions. During this procedure, a patient is under general anesthesia when a laryngoscope (a small metal tube) is placed in the mouth to provide exposure to the vocal cords themselves. A microscope is then used to visualize the vocal cords under magnification.

Depending on the type of lesion, a variety of different micro-instruments are used to restore the normal cord anatomy.

Most frequently, a tiny incision is made in the upper layer of the vocal fold away from the vibrating edge. A microflap of tissue is lifted up and the lesion is then removed from the vibrating edge of the vocal fold. The tissue flap is then re-draped to create a smooth vocal fold edge.

The procedure takes approximately 30 minutes to two hours, depending on the lesion.

Post-operative Instructions

Most patients will notice a sore throat after vocal cord surgery. Pain medicines and antibiotics may be prescribed for a few days to help with healing and your comfort.

Most patients will be asked to observe voice rest for a few days to one week following surgery. This means no talking. You will need to plan ahead to make sure you can rest your voice and follow post-operative instructions, for your best voice recovery.

For more information, see Voice Use after Voice Microsurgery.

After your vocal cord surgery, you will have scheduled follow up with the doctor, as well as the speech pathologist.

Usually, you will begin speaking again with the speech pathologist, so that you can be instructed on safe voice use during the healing process. Examination of the healing vocal fold will also be accomplished during these evaluations.

Depending on your type of voice surgery, you may note voice improvement within several weeks to three months after the surgery is accomplished.

Your participation in speech therapy during the healing period is essential to optimize the quality of your voice. Voice surgery is somewhat like joint surgery, where a period of rehabilitation is necessary to optimize function.

This article is intended as a resource for patients receiving their voice care at Duke Voice Care Center. It is not intended to substitute for medical advice from your health care team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.