Vocal cord masses include:
Types of Vocal Masses
Vocal masses may vary such as:
- Nodules are thick growths on the vocal folds that are similar to calluses. Often the result of vocally abusive behaviors, nodules typically cause changes to the voice that include hoarseness, breathiness, loss of range and vocal fatigue. Most performers are very concerned or fearful of a diagnosis of “singer’s nodules.” But this is not really an accurate term. They are more frequently caused by voice abuse that occurs during speaking than by abuse while using the singing voice. Nodules are superficial lesions of the vocal folds and are almost always treated without surgical intervention. Voice therapy is the primary modality of treatment and is curative in most patients, even if the nodules have existed for years. Accurate diagnosis is very difficult without laryngeal stroboscopy and video recording instrumentation. Vocal fold cysts and nodules are commonly confused with or misdiagnosed as other types of vocal cord lesions, but they need to be treated very differently. Therefore, it is important that they are properly evaluated by an experienced laryngologist. Most nodules, and many other benign vocal fold lesions, are not career-threatening problems when diagnosed and treated appropriately.
- Polyps occur in the middle of the vocal fold, and are usually caused by severe vocal trauma, such as yelling loudly, chronic voice abuse, vocal cord hemorrhage or chronic cough. These benign masses are typically unilateral, meaning they occur on only one vocal fold. Usually superficial, they may resolve with conservative therapy but often require surgery. If left untreated, polyps can produce a callus-like or reactive contact injury on the opposite vocal fold. This can result in misdiagnosis as nodules if not properly evaluated with laryngeal stroboscopy.
- Cysts and Pseudocysts:
- Cysts are benign, fluid-filled masses that may form on the vocal folds, and are usually non-cancerous. They occur as a result of severe vocal trauma, such as yelling loudly, chronic voice abuse, vocal cord hemorrhage or chronic cough. Pseudocysts, or retention cysts, are superficial lesions filled with mucus. True epithelial lined cysts are often deeper lesions filled with caseous material. Cysts are typically removed utilizing suspension microlaryngoscopy with a microflap excision technique, although voice therapy may be sufficient for some patients.
- Vascular Lesions:
- Vascular lesions are abnormalities of blood vessels that result in a mass on the vocal fold and/or hemorrhage into the vocal fold that results in hoarseness, inflammation, polyp or scarring. The treatment of vascular lesions of the vocal fold may include voice therapy, medication, laser photoablation and/or microlaryngeal surgery, depending upon the condition.
- Papilloma, or Recurrent Respiratory Papillomatosis (RRP), is a typically benign tumor of epithelial tissue within the larynx, trachea or throat caused by human papilloma virus (HPV). Papillomas can cause hoarseness and may grow in size to eventually block the airway, leading to a potentially life threatening obstruction. Certain high-risk subtypes of papilloma may also develop into cancer. These tumors can affect patients of all ages, and are usually recurrent. Papilloma is typically treated with laser photoablation, microlaryngeal surgery or intralaryngeal injection with cidofovir.