Benign Vocal Fold Lesions: Nodules, Cyst & Polyp

Vocal fold nodules, cysts and polyps are all benign (non-cancerous) vocal fold lesions that may occur as a result of injury to the vocal folds from prolonged and/or excessive voice use. The medical term for this is phonotrauma, and so these lesions are often referred to as phonotraumatic lesions. Each type of lesion is different, and requires specific treatment tailored to the individual. Treatment may be non-surgical – voice therapy – and/or surgical – excision or removal of the lesion(s).

Vocal Fold Nodules

Vocal fold nodules are swellings on both vocal folds due to prolonged and/or excessive voice use. These swellings are benign and are like blisters. Typically, the nodules occur at the midpoint of each vocal fold.  These swellings may get bigger and firmer with prolonged and/or repeated voice overuse. Similar to blisters, the swellings often disappear or reduce in size when the area is no longer irritated

 What causes VF nodules?

VF nodules are common in people who have a high vocal load, such as teachers and singers, but can happen to anyone.

 How do VF nodules affect my voice?

Voice is produced when the VFs come together and vibrate as air (that is breathed out by the lungs) passes between the VFs. VF nodules prevent the VFs from coming together completely. This results in a breathy and/or rough sounding voice that gets worse with prolonged voice use.

How are VF nodules treated?

Voice therapy is usually the first treatment offered. Voice therapy is a behavioural approach that helps you to use your voice in a safe and healthy way.  With voice therapy the swellings usually subside gradually. Voice therapy involves recommendations in looking after your voice and discussing techniques that are suited for your lifestyle and work. Surgery is an option if voice therapy is unsuccessful.

Vocal Fold Cyst

 A vocal fold cyst is a fluid-filled sac that develops just under the lining of the vocal fold and is buried within the vocal fold. It usually develops in only one vocal fold.  

 What causes a vocal fold cyst?

The main cause of a vocal fold cyst is prolonged and/or excessive voice use. For example, talking loudly or shouting, talking for long periods of time, and/or severe coughing.  Vocal fold cysts may affect anyone – however they are more common in people who use their voice a great deal, such as teachers and singers.

 How does a vocal fold cyst affect my voice?

Voice is produced when the vocal folds come together and vibrate as air (that is breathed out from the lungs) passes between the vocal folds. A vocal fold cyst prevents the vocal folds from coming together completely. This results in a voice that is hoarse. Your voice may sound rough, breathy or weak. A vocal fold cyst may also cause a sensation that there is something stuck in your throat that you cannot clear.

 How is a vocal fold cyst treated?

A vocal fold cyst is usually treated with surgery. This operation is called a microlaryngoscopy where the vocal fold cyst is removed via the mouth and is carried out under general anaesthetic. A vocal fold cyst sometimes disappears without surgical treatment, although this is uncommon. A voice therapist (Speech-Language Therapist) will see you before and after surgery to give you advice on how to care for your voice and optimize the surgical outcome.

Does a vocal fold cyst come back after treatment?

Surgery to remove a vocal fold cyst is successful in most cases. Recurrence (or return) of a cyst is uncommon. Voice therapy reduces the likelihood of a new cyst developing.

Vocal Fold Polyp

A vocal fold polyp is a solid mass that develops from just under the lining of the vocal fold and then protrudes from the lining of the vocal fold. It usually occurs in only one vocal fold.  

 What causes a vocal fold polyp?

The main cause of a vocal fold polyp is prolonged and/or excessive voice use. For example, talking loudly or shouting, talking for long periods of time, and/or severe coughing. A vocal fold polyp may also arise from a single episode of voice overuse. A vocal fold polyp may affect anyone – however they are more common in people who use their voice a great deal, such as teachers and singers.

What does a vocal fold polyp do to my voice?

Voice is produced when the vocal folds come together and vibrate as air (that is breathed out from the lungs) passes between the vocal folds. A vocal fold polyp prevents the VFs from coming together completely. This results in a voice that sounds hoarse and gets worse with prolonged use. A vocal fold polyp may result in a feeling that there is something “stuck” in your throat that you cannot clear.

How is a vocal fold polyp treated?

A vocal fold polyp is usually treated with surgery. This operation is called a microlaryngoscopy where the vocal fold polyp is removed via the mouth and is carried out under general anaesthetic. A vocal fold polyp can sometimes disappear without surgical treatment, although this is uncommon. A voice therapist (Speech-Language Therapist) will see you before and after surgery to give you advice on how to care for your voice and optimize the surgical outcome.

 Will I always have a vocal fold polyp?

Surgery to remove a vocal fold polyp is successful in most cases. Recurrence (or return) of a vocal fold polyp is uncommon. Voice therapy reduces the likelihood of a new vocal fold polyp developing.