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 nodules, vocal polyps, and vocal cysts 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 with better vocal hygiene, voice therapy addressing the voice patterns that caused the lesions, and surgery when necessary. Our goal is to return you quickly to your daily and professional activities. Appointments available in Durham and Raleigh.

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About Vocal Nodules, Cysts, and Polyps

Vocal nodules, vocal polyps, and vocal cysts are noncancerous growths or bumps like calluses on your vocal cords. They can cause your voice to sound raspy, breathy, hoarse, or nasal. 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, preachers, lawyers, and salespeople -- you are at greater risk for developing vocal cord nodules, polyps, or cysts. Singers are also at risk because of high vocal demands. Left untreated, vocal nodules, cysts, and polyps can lead to voice strain as you compensate for your injury.

In many cases, voice therapy can teach you how to use your voice more efficiently, 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

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 your optimal pitch and volume for strong, healthy speaking. Our singing voice therapists help professional vocal performers improve vocal range, endurance, and voice quality.

Microsurgery

In some cases, surgery may be recommended to remove noncancerous vocal cysts, vocal polyps, or nodules. 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 cyst or polyp 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.

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 those conditions.

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Tests

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 illness. 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

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.

Laryngovideostroboscopy

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. Laryngovideostroboscopy can be essential to reaching an accurate diagnosis and determining the best treatment for your voice.

Computerized Acoustic Analysis

If voice therapy is recommended for you, this non-invasive exam is completed at your second clinic visit. It creates a visual display on a computer screen as you speak into a microphone. You and your speech pathologist can see characteristics of your voice, including pitch, loudness, and vocal quality. It is used to identify abnormalities, including subtle vocal problems that cannot be detected with the unaided ear. It may be repeated during treatment to monitor your progress.

Consistently Ranked Among the Nation’s Best Hospitals

In addition, Duke University Hospital is proud to be named the best hospital in North Carolina, and nationally ranked in 10 adult and 9 pediatric specialties by U.S. News & World Report for 2019–2020.

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-language 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 under magnification -- to remove vocal cysts and polyps to achieve the best voice results.

Voice Therapy
We provide highly skilled voice therapy, an often-essential part of treatment that's not typically available at non-specialist ENT clinics.

Singing and Performing Voice Services
Whether you are a professional vocalist who needs immediate voice care services or someone who sings for enjoyment, our singing and performing-voice services will provide you expert care. You'll work with clinical singing voice specialists -- speech pathologists who are also experienced performers, singers, and singing teachers and provide specialized therapy to singers and other performers.

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

Team Care Approach
If your vocal polyps are related to another medical condition, such as allergies or asthma, we coordinate your care with other specialists to ensure you receive comprehensive treatment.

Reviewed: 02/22/2018