Vocal fold nodules, thyroid nodules, and rheumatoid nodules are some examples of nodules. Figure 1: Vocal Fold Nodule. Furthermore, vocal fold nodules occur on both sides of the vocal folds, facing each other. Generally, they are located at the middle of the membranous part of the vocal fold. Therefore, they disappear with the termination of the trauma of the vocal folds.
When vocal fold nodules are observed under the microscope, they consist of a thickened surface layer of the vocal folds and the superficial lamina propria. Moreover, the two types of vocal fold nodules are the soft or young nodules that arise due to the misuse of voice and the hard or the old vocal fold nodules that arise due to age. A polyp is a type of abnormal tissue projection from a mucous membrane. Generally, polyps occur in the colon, stomach, nose, ear, sinuses, etc.
Also, some polyps occur in the cervix, vocal folds, and small intestine. The two main types of polyps are sessile and pedunculated polyps. The sessile polyps lack a stalk, which connects the polyp to the surface while pedunculated polyps have a stalk, attaching the polyp to the surface. Vocal fold lesions are one of the most common causes of voice problems. Individuals with vocal fold nodules usually are extroverts and may have a loud voice, which can often be particularly percussive.
A vocal fold polyp typically occurs only on one side of the vocal fold. Although there may be some similarities between polyps and nodules, they look different when examined under the microscope. Polyps are typically more reddish, due to increased blood vessel supply vasculature.
A vocal fold polyp can occur in a variety of shapes and sizes. Depending upon the nature of the polyp, it can cause a wide range of voice disturbances. A vocal fold cyst is a firm mass of organized material contained within a membrane sac. The cyst can be located near the surface of the vocal fold or deeper, near the ligament of the vocal fold. As with vocal fold polyps and nodules, the size and location of vocal fold cysts affect the degree of disruption of vocal fold vibration and subsequently the severity of hoarseness or vother oice problem.
Voice therapy following surgery is typically recommended to maximize vocal recovery after surgery and prevent a recurrent lesion. Other polypoid lesions, often bilateral, arising from tobacco abuse or hypothyroid states, should initially receive medical management. Cold-knife microsurgical excision during direct microlaryngoscopy is preferable to laser excision, which is more likely to cause collateral thermal injury if improperly applied. In microlaryngoscopy, an operating microscope is used to examine, biopsy, and operate on the larynx.
Images can be recorded on video as well. The patient is anesthetized, and the airway is secured by high-pressure jet ventilation through the laryngoscope, endotracheal intubation, or, for an inadequate upper airway, tracheotomy. Because the microscope allows observation with magnification, tissue can be removed precisely and accurately, minimizing damage possibly permanent to the vocal mechanism.
Laser surgery can be done through the optical system of the microscope to allow for precise cuts. Microlaryngoscopy is preferred for almost all laryngeal biopsies, for procedures involving benign tumors, and for many forms of phonosurgery. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Videos Figures Images Quizzes Symptoms. Symptoms and Signs. Key Points. This approach only occurs when the nodules or polyps are very large or have existed for a long time.
Medical problems may be treated to reduce their impact on the vocal cords. This includes treatment for acid reflux disease GERD , allergies, and thyroid problems. Medical intervention to stop smoking or to control stress is sometimes needed. Many people receive behavioral intervention or voice therapy.
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