Vocal cord Polyps/Nodules are the unwanted benign (noncancerous) growths (mass of tissue) on both vocal cords that are caused by overuse of vocal cords. The most common site of appearance of these benign growths are on the junction of anterior and posterior of the vocal cords as the contact is most forceful here.
The vocal cord nodules appear in the form of symmetrical swellings on both sides of the vocal cords. The major cause of the formation of the vocal cord nodule is the overuse, strenuous or abusive voice practices such as yelling and coughing. The individuals who use their voice constantly in a loud environment are more susceptible to the formation of vocal cord polyps/nodules.
The vocal cord polyps take a number of forms. Long term repeated abuse of the vocal cords will lead to formation of soft, swollen spots on each vocal cord. These spots with time develop into harder, callous-like growths which are known as nodules. Then these nodules later on become larger and stiffer as long as the vocal abuse continues.
Polyps appear on one vocal cord or both the vocal cords. They appear in the form of swelling or a bump (like a nodule), a stalk like growth or even in some cases a blister –like lesion. In some cases polyps appear larger than nodules and may be called as polypoid degeneration or Reinke’s edema.Age / Sex group affected by Vocal Cord Polyps/Nodules
Vocal cord polyps can occur at any age.
Occur in those individuals who make overuse of their voice.
Both males and females are equally affected.
Individuals of any race are prone to develop vocal cord polyps.
The major cause of formation of vocal cord nodules is by overuse, misuse or abuse of voice.
Vocal nodules occur more frequently in women between the ages of 20-50.
Polyps may also be caused by a single traumatic event to the vocal cords such as yelling at a concert.
Other causes of formation of vocal cord polyps are as follows
• Long-term cigarette smoking.
• Tense muscles.
• Drinking caffeine and alcohol.
• Talking loudly.
Symptoms of nodules and polyps are similar and are given below
• Hoarseness of voice.
• Voice becomes rough.
• A scratchy voice.
• Harshness in throat.
• Shooting pain from one ear to another.
• There is sensation of lump in the throat.
• Pain in neck.
• There is decrease in pitch.
• There occur voice and body fatigue.
Cases of vocal cord polyps are diagnosed by looking at following points.
Hoarseness of voice for more than 2-3 weeks indicates there is formation of polyps or nodules.
A complete voice evaluation should include following steps
• There is examination by the physician preferably by an otolaryngologist and through examination of ear, nose and throat is done.
• Proper evaluation of voice by a speech-language pathologist.
• Neurological examination is also required to be done.
Then after this the quality, pitch, loudness, ability to sustain voicing is evaluated by the team of specialists.
There is also done an instrumental examination by inserting an endoscope into the mouth or nose to look at the vocal cords.
Stroboscope is also used to watch the vocal cords.
Videostrobolaryngoscopy is helpful for detecting the lesion sites.
In professionals like singers and jobs of who are related to loud speech have to change the job otherwise surgery is done and in some cases lead to development of cancer also.
Following treatment steps are helpful
• Voice rehabilitation.
• Speech therapy.
• Vocal rest.
• Removal of vocal cord nodule with minor surgery is helpful.
• Stop smoking.
• Less use of loud voice.
• Stress reduction techniques and relaxation exercises of throat are done
Most common complications after surgery are
• Tongue numbness after surgery
• Altered taste
• Minor trauma to the teeth, Oral cavity, pharynx.
Risks come along with phonomicrosurgery are as follows
• Worsened voice quality
• Dental trauma
• Oropharyngeal injurydue to larayngeal suspension
• Scar formation due to overaggressive tissue resection
• Squamous papillomas of throat
• Spastic dysphonia
• Glottis carcinoma
• Cord paralysis
• There is abundant, thick mucus in the throat.
• The throat is raw, rough and sore.
• There is sensation of splinter in the throat
• Throat is dark red in appearance.
• Throat feels strangulated.
• Well indicated medicine to treat vocal cord polyps.
• The throat is swollen especially of right side.
• Throat feels dry and constricted.
• Indicated medicine for ulcerations of mouth and fauces with dry, burning sensation.
• Very good medicine for vocal cord nodules and polyps.
• Tongue is white and scalded.
• The throat is rough, constricted and burning.
• Right tonsils are sore.
• Very well indicated medicine for vocal cord polyps and nodules.
• Throat is swollen, oedematous.
• Throat feels constricted with burning and unable to swallow.
• There are present diphtheritic membrane due to which throat looks dry and wrinkled.
• Well indicated medicine for vocal polyps.
Hepar sulphuris calcareum
• On swallowing, sensation of a plug and of a splinter in the throat.
• Quinsy with impending suppuration.
• Patient complains of stitches in throat extending to the ear on swallowing.
• Hawking up of mucus.
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