Laryngology
Vocal Cord Nodules and Polyps
Microlaryngeal surgery, voice-therapy integration, post-operative voice-rest.
What is the difference between vocal-cord nodules, polyps, and cysts?
Vocal-cord nodules, polyps, and cysts are distinct pathologies. Nodules: bilateral, symmetric, callus-like lesions — result from chronic vocal abuse (teachers, singers); respond to voice therapy. Polyps: unilateral, soft, fluid-filled lesions — develop after acute vocal trauma (loud shouting, cough); usually need surgery. Cysts: subepithelial fluid collection beneath the mucosa, of deeper cartilage origin; surgery is primary. Stroboscopy differentiates all three. Treatment principle: conservative first (voice therapy, anti-reflux); if needed, microlaryngeal surgery + 7–10 days post-op voice rest + 4 weeks voice therapy.
Microlaryngeal surgery process
Performed under general anaesthesia in 30–90 minutes. Direct laryngoscopy exposes the larynx; lesions are removed with precise micro-instruments or CO2 laser under a microscope. Mucosal preservation is critical — no cartilage damage during Reinke-space dissection.
Critical post-op rule: 7–10 days of complete voice rest (whispering also banned; if necessary, short phrases). Voice therapy begins in the next 4 weeks. Professional voice users (teachers, singers) return to stage at 8–12 weeks. Concurrent reflux treatment and vocal hygiene reduce recurrence.
Process
- 1
Consultation
1–2 weeks priorStroboscopic exam, voice-therapy trial, anti-reflux therapy initiation.
- 2
Surgery
30–90 minutesGeneral anaesthesia, direct laryngoscopy, microsurgery.
- 3
Discharge
Same daySame-day discharge, voice-rest protocol starts.
- 4
Voice rest
7–10 daysComplete voice silence, whispering banned, soft diet.
- 5
Voice therapy
4 weeksWeekly speech-therapist sessions, gradual voice return.
- 6
Full return
8–12 weeksReturn to professional voice use, control stroboscopy.
Frequently Asked Questions
- No. First-line is voice therapy (8–12 weeks). Surgery is considered for those not responding to conservative therapy, or for professional voice users with planned scheduling.
- Yes for most. Microsurgery + voice therapy gives 85–90% success. Lesion size and accompanying vocal abuse affect the outcome.
- The hardest part. Written communication (text, notes), short phone calls (when necessary), early notification of family/workplace are recommended. 7–10 days of complete voice rest needs planning.
- Whole-vocal-cord oedema from smoking and vocal abuse. Smoking cessation + voice therapy + microlaryngeal fluid evacuation in advanced cases.
- With vocal hygiene + reflux treatment, recurrence is 10–15%. Without education, recurrence is 30–40%.
References
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