Vocal folds are two mucous membrane-covered horizontal folds of tissue located inside the larynx that are responsible for voice production. Benign neoplasms often occur in the area of these vocal folds. Among other things, these can be the result of incorrect speech or surgical interventions with intubation, which can lead to thickening of the vocal folds and even to the formation of polyps ( vocal fold polyp ).
What is a vocal cord polyp?
A vocal fold or vocal cord polyp is a benign change that occurs exclusively on the free edge of the vocal fold or on the subglottic slope of the front third of the vocal fold. While smaller polyps are broad-based, larger forms are spherical and stalked. 90% of the time vocal cord polyps occur on one side only. For what is keratoacanthoma used for, please visit fun-wiki.com.
A distinction is made between edematous (swelling due to accumulations of fluid), myxomatous (from unformed mucous and connective tissue basic substance) or telangiectatic (enlarged, small, superficial skin vessels) pseudotumors. The surfaces of vocal cord polyps are glassy, smooth, spherical, and reddish in color. Malignant changes in these polyps are not known.
The causes of the development of vocal cord polyps, which are common in middle-aged men, are unclear. It is possible that there is a connection with vocal overload. Since the polyps occur more frequently in cigarette smokers, smoking is also a possible cause. Chronic inflammation and pro-inflammatory noxae such as heat, smoke, dust, corrosive vapors, etc. can also be the cause of vocal cord polyps.
Symptoms, Ailments & Signs
A vocal cord polyp is characterized by hoarseness, a scratchy throat, and other voice disturbances. Coughing, difficulty breathing and a foreign body sensation in the throat also occur. The hoarseness is the most obvious symptom and is usually permanent. Depending on the size of the polyp and where it is located, there can be changes in voice color or even complete loss of voice.
The voice of those affected often sounds rough and double-toned, although the color of the voice can vary greatly as the disease progresses. Accompanying this, fibrous inflammation can occur near the vocal folds. These repeatedly cause shortness of breath and suffocation attacks, in the worst case the patient can die.
If treatment is delayed or absent, the typical throat problems become so severe that the quality of life is severely restricted. Inflammation can lead to bacterial superinfection. The pathogens can then spread to the surrounding body regions and, in the worst case, cause sepsis.
Blood poisoning is manifested, among other things, by fever and an increasing feeling of illness. Assuming rapid therapy, the symptoms can be alleviated in a targeted manner. One to two weeks after the removal of the vocal fold polyps, the patients are usually symptom-free again.
Diagnosis & History
A vocal fold polyp can cause a more or less pronounced hoarseness or a double tone of the vocal sound (diplophony). When the vocal cord polyp moves back and forth in the glottis during phonation and breathing, the intensity of the hoarseness changes again and again.
Patients can have a foreign body sensation and also suffer from a dry cough or a constant urge to clear their throat. Larger polyps or vocal folds that are additionally swollen due to inflammation can even lead to suffocation.
A laryngoscopy, a so-called laryngoscopy, is performed to detect tissue changes on the vocal folds. The doctor looks at the patient’s vocal cords and larynx using a small mirror that is inserted through the mouth and down the throat. Nasal endoscopy is another helpful examination method.
The nasal endoscope is a flexible thin tube. This is passed through the nostrils down into the throat. Thanks to a light source and a miniature camera at the tip of the endoscope, the doctor can view the vocal folds. Small forceps can also be inserted through the endoscope, e.g. B. to take tissue samples.
As a rule, vocal cord polyps that are treated in a timely manner are not accompanied by serious complications. In the event of an unusual course or delayed treatment, the typical symptoms such as hoarseness, polyphony of the voice as well as coughing and scratchy throat or other throat problems can become so severe that there can be a very severe impairment or even a loss of voice temporarily.
Complications can also arise if the polyps have to be surgically removed. Although the removal of a vocal fold polyp is only a small and usually harmless procedure, certain risks cannot be completely ruled out. Heavy bleeding can occur during or after the procedure.
Minor injuries to the mucous membranes can also lead to the patient suffering from swallowing difficulties for some time after the operation. After the surgical removal of a vocal cord polyp, many patients show hoarseness, which in severe cases can last for several weeks.
Inflammation of the surgical wound, on the other hand, is rare, but still possible. This can necessitate treatment with antibiotics, which is often associated with unpleasant side effects. Even after the polyp has been successfully removed, speech therapy may be required to fully restore voice.
When should you go to the doctor?
A vocal cord polyp usually always requires medical treatment. Since this disease cannot heal on its own and the symptoms usually continue to worsen if left untreated, a doctor should always be contacted at the first signs and symptoms of the disease.
The doctor should be consulted if the patient suffers from severe hoarseness. This can also lead to breathing difficulties, so that the patients often feel tired and exhausted. It is also usually difficult for those affected to carry out strenuous activities. It is not uncommon for severe shortness of breath to indicate the vocal fold polyp and must also be examined by a doctor. Most of those affected also have a fever and, if left untreated, develop blood poisoning, which can lead to death.
A general practitioner or an ENT doctor can be consulted in the case of a vocal fold polyp. The treatment itself is then carried out by a specialist and usually leads to success without complications.
Treatment & Therapy
The vocal fold polyps are usually removed in a minor operation using an endoscope. Similar to nasal endoscopy, this is advanced through the mouth to the larynx. All the instruments required for the operation are located at the tip of this endoscope.
Using small forceps or a laser, the polyp is removed from the mucous membrane under a microscope. This operation is also possible under local anesthesia by special phonosurgeons. The material removed during the procedure should always be examined histologically by a specialist to confirm the diagnosis and rule out a malignant tumor.
Following the microsurgical removal of vocal cord polyps and after elimination of unfavorable accompanying circumstances, logopedic voice therapy is necessary in most cases.
Since the basic causes for the development of vocal cord polyps have not yet been clarified, it is hardly possible to prevent this disease directly. But if a few basic things are observed, the risk can be reduced.
When acute hoarseness develops, it is better to refrain as much as possible from talking and from anything that further irritates the throat. In addition to nicotine and alcohol, this also includes spicy foods. Clearing the throat should be avoided as the vocal folds hit each other violently, which in the long run can lead to inflammation of the vocal folds.
People who have to use their voice a lot (singers, teachers or journalists) are particularly at risk of hoarseness and should pay particular attention to the correct use of their voice.
After the surgical removal of the vocal fold polyp, care should be taken during follow-up care to ensure that the patient rests their voice for about three to ten days. This allows the surgical wound to heal more easily and the tissue defect to regenerate better. However, if the patient has to speak from time to time, whispering should be avoided.
Whispering puts more strain on the vocal cords. It is therefore considered more sensible to speak in a normal tone. If bleeding occurs after the operation, it is important to contact the doctor. In addition, the patient must not eat spicy or hot meals for about a week after the surgical procedure.
Likewise, the consumption of tobacco products and alcohol must be completely avoided while the surgical wound is healing. Alcohol in particular increases the risk of bleeding.
Once the phase of voice rest is over, it is recommended to carry out voice therapy exercise therapy. It is particularly advisable after vocal fold polyps have developed over a longer period of time, because over time vocal pressure patterns become more entrenched.
How long the voice exercise treatments need to take place depends on how the patient responds individually to the various exercises. In most cases, the therapy takes about four to six weeks.
You can do that yourself
In everyday life, the consumption of nicotine should generally be avoided. This has a negative impact on the health of those affected in various areas. It is therefore advisable to stop smoking both actively and passively in good time.
Smoking does not only include the consumption of cigarettes and cigars. No pipe, shisha or e-cigarette should be smoked. Since the smoke from the products can generally be inhaled through the air, no places should be visited where people smoke. Otherwise, the pollutants could also get into the organism via so-called passive smoking. In addition, environments should be avoided where dust or corrosive fumes are found in the air.
In everyday life, it is important to ensure a good and healthy supply of oxygen. Rooms should be ventilated regularly and staying outdoors is advisable. In the case of leisure activities, it is also important to pay attention to which places are visited and what the local conditions are like.
As soon as complaints of the vocal environment are perceived, speaking should be avoided if possible. Communication is to be kept to a minimum. It is advisable to protect the neck by wearing clothing such as a scarf or a sling. Especially at a change of season or in cold surroundings, the affected person should protect themselves adequately with these accessories.