Vocal cord nodules and polyps

Vocal cord nodules and polyps: Excerpt from Professional Guide to Diseases (Eighth Edition)

Vocal cord nodules result from hypertrophy of fibrous tissue and form at the point where the cords come together forcibly. Vocal cord polyps are chronic, subepithelial, edematous masses. Both nodules and polyps have a good prognosis unless continued voice abuse causes recurrence, with subsequent scarring and permanent hoarseness.

Causes and incidence

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.

Pediatric tip  In children, papillomas of the larynx (benign warty growths) are the most common laryngeal neoplasm. Suspected causes include human papillomavirus types 6, 11, and 16. The virus may be acquired during birth because many mothers have a history of condylomata acuminata at the time of delivery.

Signs and symptoms

Nodules and polyps inhibit the approximation of vocal cords and produce painless hoarseness. The voice may also develop a breathy or husky quality.

Diagnosis

Persistent hoarseness suggests vocal cord nodules and polyps; visualization by indirect laryngoscopy confirms it. In the patient with vocal cord nodules, laryngoscopy initially shows small red nodes; later, white solid nodes on one or both cords. (See Vocal cord nodules.) In the patient with polyps, laryngoscopy reveals unilateral or, occasionally, bilateral, sessile or pedunculated polyps of varying size, anywhere on the vocal cords.

Treatment

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 for any underlying allergies.

When conservative treatment fails to relieve hoarseness, nodules or polyps require removal under direct laryngoscopy. Microlaryngoscopy may be done for small lesions, to avoid injuring the vocal cord surface. If nodules or polyps are bilateral, excision may be performed in two stages: one cord is allowed to heal before excision of polyps on the other cord. Two-stage excision prevents laryngeal web, which occurs when epithelial tissue is removed from adjacent cord surfaces, and these surfaces grow together. 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 can understand the need to abstain from voice abuse.

Special considerations

❑ Postoperatively, stress the importance of resting the voice for 10 to 14 days while the vocal cords heal. Provide an alternative means of communication — Magic Slate, pad and pencil, or alphabet board. Place a sign over the bed to remind visitors that the patient shouldn’t talk. Mark the intercom so other facility personnel are aware that the patient can’t answer. Minimize the need to speak by trying to anticipate the patient’s needs.

❑ If the patient is a smoker, encourage him to stop smoking entirely or, at the very least, to refrain from smoking during recovery from surgery.

❑ Use a vaporizer to increase humidity and decrease throat irritation.

❑ Make sure the patient receives speech therapy after healing if necessary, because continued voice abuse causes recurrence of growths.

Pictures

Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

More About Larynx Cancer

• Back to disease: Larynx Cancer: Introduction
• Next Book Extract About Larynx Cancer: Hoarseness (Professional Guide to Signs & Symptoms (Fifth Edition))
• More Book Extracts: All Online Books for Larynx Cancer

More Medical Textbooks Online about Larynx Cancer

Review other book chapters online related to Larynx Cancer:

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X

 » Next page: Hoarseness (Professional Guide to Signs & Symptoms (Fifth Edition))

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• Hoarseness (Professional Guide to Signs & Symptoms (Fifth Edition))
• Stridor (Professional Guide to Signs & Symptoms (Fifth Edition))
• Cough, barking (Professional Guide to Signs & Symptoms (Fifth Edition))
• Cough, nonproductive (Professional Guide to Signs & Symptoms (Fifth Edition))
• Cough, productive (Professional Guide to Signs & Symptoms (Fifth Edition))

Tools & Services:

• Bookmark this page
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com

Common Health Mistakes

Symptom
Checker

Search Specialists by State and City