The vocal cords are located at the back of throat on the top of trachea. Trachea is the tube through which air enters into the lungs. They are thin band of two muscle tissue in the voice box. The vocal cords in voice box (larynx) vibrate to produce voice. Vocal cord dysfunction can lead to several symptoms such as hoarseness of voice, loss of voice, low pitch, breathing problem mainly when the nerve supplying vocal cord is damaged.
Vocal cord problems can develop either due to lesions of vocal cord or infection or inflammation of the voice box.Most lesions of vocal cord are benign. The lesions can occur in voice box or around it. These lesions cause problem with the voice. The lesions of vocal cord are of several types. They may be present as nodes, polyp, cyst, or reactive lesions. Most vocal cord lesions develop due to straining of voice. Shouting, screaming, smoking, allergies all can make the condition worse.
Types Of Vocal Cord Lesions
Vocal cord lesions are mainly of 4 types.
- Nodules in vocal cord: They are also known as screamers node. Tiny node develops on vocal cord. The node can develop on both the vocal cords or on single cord. It appears like a callus on skin surface. Just like skin calluses, the nodes vanish when overuse is stopped. In this case overuse of voice.
- Polyp on the vocal cord: Polyps generally occur on one vocal cord. They may be of different size and shape. Polyps can cause voice related problems.
- Cyst on vocal cord: A vocal cord cyst is a mass in the ligaments of vocal cord muscles. Vocal cord cyst can be big or small depending on its size the degree of hoarseness can vary.
- Reactive lesion: It is a growth that develops just opposite of a node or a polyp mass. This type of lesion occurs when the polyp or the node on one cord repeatedly causes injury and friction to other vocal cord. Voice rest can reduce the lesion.
What Causes Vocal Cord Lesions?
The most common causes that may lead to formation of vocal cord lesions are:
- Overuse and abuse of voice. For example excessive loud voice as while delivering a speech in front of an audience or teacher speaking loudly in front of students.
- Thyroid disease which causes dysfunction of thyroid gland and subsequently thickening of the vocal cord.
- Chronic sinusitis which causes repeated post nasal drip. Clearing the throat in such case can cause strain on the voice box and vocal cords situated in it.
- Gastrointestinal reflux can cause damage to the laryngeal mucosa which acts as a protective covering to the vocal folds.
- Smoking has close association with vocal cord lesions.
Symptoms Of Vocal Cord Lesions
Benign vocal cord lesions produce change in the voice depending how severe is the lesion. The change of voice can be while speaking or even singing. Most of the time patient may have hoarseness of voice as soon as he tries to talk. With constant usage of hoarse voice, there is subsequent fatigue of voice and the extremely diminishes.
The voice is low pitched and breaks in between speaking. The sound quality of voice is different. Patient is unable to sing in high pitched voice. Besides hoarseness, patient constantly is seen clearing his throat as if something has stuck inside his throat. To speak patient applies extra force.
Treatment For Vocal Cord Lesions
Vocal cord lesions are benign pathology. Treatment is aimed at improving the quality of voice and to prevent further deterioration of voice. Giving rest to voice when it is overused is the key for bringing back the original voice. It also reduces the lesions especially if it is a node or a polyp.
Besides giving rest to voice, various other therapies are initiated in patient suffering from lesion on the vocal cord. If the voice quality is extremely deteriorated due to the lesion, microsurgery of the lesion is useful treatment. During the surgery the lesion is removed and post surgery voice therapy is started to improve the functional voice.