What are these Conditions?

Nodules and polyps are types of benign growths that may appear on the vocal cords. Both nodules and polyps have good prognoses, un­less continued voice abuse causes recurrence, with subsequent scarring and permanent hoarseness.

What Causes them?

Vocal cord nodules and polyps usually result from voice abuse, especially in the presence of infection. Consequently, they’re most common in teachers, singers, and sports fans, and in energetic children (ages 8 to 12) who continually shout while playing. Polyps are common in adults who smoke, live in dry climates, or have allergies.

What are their Symptoms?

Nodules and polyps inhibit the movement of the vocal cords and produce painless hoarseness. The voice may also sound breathy or husky.

How are they Diagnosed?

If a person has persistent hoarseness, the doctor may suspect vocal cord nodules and polyps. To confirm the diagnosis, the vocal cords may be visualized using a test called indirect laryngoscopey. In a person with vocal cord nodules, laryngoscopy initially shows small red nodes; later, white solid nodes will be seen on one or both cords. In a person with polyps, laryngoscopy reveals polyps of varying size, which may appear anywhere on the vocal cords and may occur on one or both cords.

How are they Treated?

Conservative management of small vocal cord nodules and polyps includes humidification, speech therapy (voice rest, training to reduce the intensity and duration of voice production), and treatment of any underlying allergies.

When conservative treatment fails to relieve hoarseness, the doctor will remove nodules or polyps under direct laryngoscopy. The doctor may use microlaryngoscopy for small lesions to avoid injuring the vocal cord surface.

If nodules or polyps are present on both cords, surgical removal may be performed in two stages so that one cord can heal before polyps are removed from the other cord.

For children, treatment consists of speech therapy. If possible, surgery should be delayed until the child is old enough to benefit from voice training, or until he or she can understand the need to abstain from voice abuse.