Vocal Cord Nodules, Cysts, and Polyps

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Experts at Duke Voice Care use sophisticated diagnostic tools and the latest techniques to identify and treat vocal cord (also known as vocal fold) nodules, vocal cord cysts, and vocal cord polyps in adults and children. Our advanced training, skill, and experience ensure you receive the best possible care for these noncancerous growths on your vocal cords. We help you improve your voice by providing tips for better vocal hygiene, voice therapy to address the voice patterns that may have led to the lesions, and surgery when necessary. Our goal is to return you quickly to your daily and professional activities.

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About Vocal Nodules, Cysts, and Polyps

Vocal cord nodules, vocal cord cysts, and vocal cord polyps are noncancerous growths or bumps like calluses on your vocal cords. They can cause your voice to sound raspy, breathy, or hoarse. Your voice may crack or cut in and out as the bumps prevent your vocal cords from vibrating normally.

Voice overuse -- such as talking too loudly or too much -- is frequently the cause of these growths, but they can also result from constant coughing, acid reflux, or allergies. If your profession demands you speak constantly and with a loud voice -- as with teachers, clergy, lawyers, and salespeople -- you are at greater risk for developing vocal cord nodules, cysts, or polyps. Singers are also at risk because of their high vocal demands. Left untreated, the growths can lead to voice strain as your body attempts to compensate for your injury.

In many cases, voice therapy can teach you how to use your voice more efficiently and without strain so your injury heals. In some cases, surgery is needed to remove the growths. After surgery, voice rehabilitation is essential to ensure your best vocal recovery.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments for Vocal Cord Nodules, Cysts, and Polyps

Voice Therapy

Voice therapy promotes healing of your vocal cord injury and helps you avoid future injury. Our speech pathologists guide children and adults through vocal exercises to improve breathing, reduce throat strain, and find optimal resonance, pitch, and volume for strong, healthy speaking. Our singing voice therapists help professional vocal performers improve vocal range, endurance, and voice quality. This therapy is often an essential part of voice recovery that's not typically available at non-specialist ENT clinics.

Microsurgery

In some cases, surgery may be recommended to remove noncancerous vocal cord nodules, cysts, or polyps. While you are under general anesthesia, tiny surgical instruments are inserted through your mouth into your throat. The surgeon makes a very small incision away from the vibrating edge of your vocal cord, and a tiny flap of tissue is lifted so the growth can be removed. Also known as "phonomicrosurgery," this technique reduces the risk of scarring and offers the best voice outcomes. Voice therapy after microsurgery is essential for optimal recovery.

Vocal Cord Laser Surgery

Some types of vocal cord lesions can be removed with a laser. This procedure can be done in a doctor’s office while you are awake or in the operating room under general anesthesia. The surgeon inserts a thin scope into your nose and throat and uses laser beams to shrink the lesion. Voice rest and voice therapy are usually necessary after this procedure. Some patients need a second procedure to fully remove the vocal cord lesion.

Medical Management

Your laryngologist may prescribe medications to treat chronic cough, acid reflux, allergies, and other medical problems that may contribute to voice disorders. When needed, your laryngologist will refer you to the appropriate specialist for further treatment of these conditions.

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Tests for Vocal Cord Nodules, Cysts, and Polyps

A comprehensive evaluation assesses your voice use patterns -- how much you speak, sing, or use a loud voice, and what your voice sounds like. Your laryngologist will evaluate the role of any medical conditions that can cause voice changes, such as surgeries or recent illnesses. We will perform a head and neck examination and a visual examination of your voice box. Tests may also be necessary to create an individualized treatment plan.

Singing Voice Evaluation

For singers, a thorough singing voice evaluation assesses your pitch/vocal range, loudness range, vocal stamina, breath support, resonance, and register transitions. Our singing voice specialists will identify any muscle tension that may be contributing to your voice problem and evaluate your vocal technique relative to your singing style. We also identify strategies to optimize your vocal hygiene and vocal pacing. If needed, we will advocate for your vocal health with directors, producers, tour managers, and other artistic personnel. If you are a performer and have an urgent need for a voice evaluation prior to a performance, please call 919-681-4984 to arrange a timely appointment.

Videolaryngostroboscopy

This detailed visual exam helps us evaluate how your vocal cords vibrate while you speak or sing. A tiny camera attached to a small tube called an endoscope is inserted through your nose and allows us to see your vocal cords and larynx (voice box). A flashing strobe light simulates slow motion video images of your vocal cords. The exam takes only about a minute, and your nose may be sprayed with topical anesthetic for your comfort.

The exam allows your team to look for lesions, stiffness, paralysis, irregular movements, throat strain, or incomplete closure of the vocal cords. After the exam, your team will review the images with you to determine an accurate diagnosis and treatment plan together. Videolaryngostroboscopy is essential to reaching an accurate diagnosis and determining the best treatment for your voice.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2020–2021.

Why Choose Duke

Highly Specialized Providers
You'll have access to one of the few comprehensive voice care programs in the Southeast and its team of voice experts. Our specialists work with you to determine the extent of your condition and treat it promptly and effectively. Your care team will include laryngologists -- ear, nose, and throat (ENT) doctors with advanced training in voice disorders -- and speech pathologists who specialize in treating voice disorders.

Experienced ENT Surgeons
Our ear, nose, and throat (ENT) surgeons have advanced training and experience in microsurgery -- which employs small incisions and tools used with magnification -- to remove vocal cysts and polyps to achieve the best voice results.

Occupational Voice Therapy Services
If your profession puts you at risk for developing vocal nodules, cysts, or polyps, our occupational voice specialists will work with you to improve your voice and safely meet the demands of your job.

Team Care Approach
If you have other medical conditions that may contribute to your voice issues -- such as allergies, asthma, or acid reflux -- we will work with your other providers throughout Duke Health to ensure you receive the best care from an integrated team.

Reviewed: 09/09/2020