A vocal fold Cyst is a collection of fluid, usually mucus, contained within a membrane. The Cyst is often located near the surface of the vocal fold underneath the mucosa. Although it is not entirely clear how Cysts form, many believe that they result from mucous glands that have become blocked. It is believed that vocal fold irritation from misuse of the voice may contribute to their formation.
The size and location of the vocal fold Cyst affect the degree of disruption of vocal fold vibration and subsequently, the severity of hoarseness. It is rare to experience any pain. Occasionally, the voice change may be accompanied by a sensation of a foreign body in the area of the voice box (sense of a “lump in the throat”) and a feeling of the need to clear the throat or cough.
Voice rest often reduces the hoarseness due to reduction of surrounding swelling. However, since it is rare for a Cyst to resolve on its own, removal of the Cyst is often recommended. Surgery followed by voice therapy is the most commonly recommended treatment for vocal fold Cysts. Micro-laryngoscopy is the most precise means of operating on the vocal folds. All surgery is performed under general anesthesia, via a laryngoscope, an instrument inserted through the mouth to view the larynx directly. There are no skin incisions. A microscope is used for magnification of the field of surgery and micro-instruments are utilized. Complete removal of the Cyst is required in order to avoid recurrence. In addition, overlying mucosa must be preserved and draped over the area where the Cyst was removed to minimize the chance of scarring.
Following surgery, medication and/or voice therapy are often prescribed to eliminate the vocal fold irritation and misuse that led to development of the Cyst.