Phonotrauma (Benign Vocal Fold Lesions)
What is Phonotrauma?
Your vocal cords vibrate very fast, with collisions of one side against the other at frequencies of hundreds of times per second. If the voice is used too much or improperly, these collisions can lead to the development of lesions on the vocal cords that affect how they come together and/or vibrate, a condition called phonotrauma. People who use their voice consistently such as singers, performers, teachers, lawyers, doctors, broadcasters and salespeople are most susceptible to phonotrauma.
Phonotrauma can manifest a number of different ways:
Vocal nodules (callouses) are superficial lesions on the lining of the vocal cords and usually occur in the middle of both vocal folds.
A vocal cord polyp (blister), usually on one vocal cord, can be soft or firm and can be clear or red from hemorrhage.
A vocal cord cyst is deeper in the vocal fold, under the superficial lining. Many are believed to start following phonotrauma, but some may be there from birth and grow very slowly with time.
Ectasias are dilated or abnormal blood vessels under the surface of the vocal cord that can bleed and cause focal fold stiffness.
Vocal cord sulcus, or an indentation along the inner edge of the vocal cord, is caused by vocal cord scarring and can lead to reduction in vocal cord vibration.
Treatment of benign phonotraumatic vocal cord lesions depends on a number of factors, including the nature of the lesion, your particular voice needs, and your degree of voice difficulty. Your treatment team will develop a personalized treatment plan.
Voice therapy with a speech-language pathologist can cure some types of vocal cord lesions. Using appropriate vocal technique can help you manage your vocal symptoms even if the lesion still remains, and prevent problems from reoccurring or worsening with time. It is often recommended either alone or in combination with other treatments.
Phonosurgery is performed when a lesion on the vocal cords does not (or is not expected to) completely respond to voice therapy. The goal of phonosurgery is to remove the lesion in question and preserving adjacent areas of normal vocal cord tissue that are crucial for preserved vocal cord vibration. Even when surgery is needed, voice therapy is often still advised to ensure proper voice use during the healing process after surgery.
In some circumstances, a phonotraumatic lesion on the vocal cords may be well-suited for in-office treatments including vocal fold injections or KTP laser treatments.