Vocal folds Polyps are non-cancerous growths that have a variety of appearances. Vocal fold irritation from misuse of the voice and smoking contribute to their formation. They are typically located at the mid portion of the vocal fold, may be single or multiple, involve one cord or both and may be big or small. Polyps may be hanging by a thin stalk (pedunculated) or have a wide base (sessile). Vocal fold Polyps are non-cancerous (benign); however, benign lesions cannot always be distinguished from a malignant one by an examination in the office and therefore, a biopsy may be necessary to determine if the lesion is cancerous.
Polyps may produce a variety of symptoms, depending on their size and location. The main symptom is painless hoarseness. The presence of Polyps disturbs the normal vibration and closure of the vocal folds, resulting in hoarseness. Other symptoms may include the frequent need to clear the throat, coughing and trouble swallowing. Larger lesions can obstruct the larynx, resulting in difficulty breathing.
Treatment of Polyps varies and is dictated by the cause of the Polyp, as well as its size and location. For smaller Polyps, voice rest often reduces the hoarseness due to reduction of surrounding swelling, but does not address the root of the problem.
Voice therapy is almost always recommended in order to make the patient aware of the type of voice use that has led to the problem, and to find strategies to limit the irritation.
Small Polyps caused by smoking may be treated with smoking cessation alone. Large Polyps often require surgical excision. Micro-laryngoscopy is the most precise means of operating on the vocal folds. All surgery is done 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. Great care must be taken to preserve the overlying mucosa in order to minimize the chance of scarring. Following surgery, medication and/or voice therapy is often prescribed to eliminate the vocal fold irritation and misuse that led to development of the Polyp.