Medical and Surgical Treatment of Voice Disorders
Benign Tumors of Vocal Cords
Vocal Cord Polyp
It is a lesion developing after a bleeding under vocal cord epithelium following an acute vocal trauma (such as shouting) in general. It is unilateral almost at all times. Mostly seen in middle age males. Causes coarseness as a complaint. Treatment method is surgical excision.
Vocal Cord Nodule:
Benign lesions developing as a result of chronic vocal trauma associated with wrong phonation technique. Typically, the nodules are bilateral and are located at 1/3 front – 2/3 back connection point where vocal cords contact each other most. It is also termed as “singnodule”. Its incidence is higher in professional groups using voice for professional purposes (teachers, vocal artists, politicians and stallholders). Causes hoarseness as a complaint. Treatment method is firstly speech therapy. Surgical excision is performed for fibrotic nodules which do not respond to voice therapy.
Contact Granuloma and Intubation Granuloma/h3>
Contact granuloma is reported generally at middle ages in males. It is mostly associated with functional causes such as chronic vocal trauma, and thus, it corresponds to vocal cord noddle in females. Intubation granuloma develops a few weeks after endotracheal intubation (tube orally implanted to trachea under general anesthesia). Causes hoarseness as a complaint. Treatment method is firstly speech therapy. Surgical excision is performed for fibrotic nodules which do not respond to voice therapy.
Vocal Cord Cysts
These thin-walled serous or mucous content cysts are almost entirely located in Reinke’s space (immediately beneath vocal cord mucosa). Rarely, they are located inside deep muscles. Its etiology is firstly associated with occlusion of opening of mucous glands. Causes hoarseness as a complaint. Treatment method is surgical excision.
Vocal Cord Papilloma and Juvenile Papilloma (Papillomatosis)
Its etiology is believed to be associated with Human Papilloma Virus type 6 and 11. Mostly seen in middle age males. They are considered as pre-carcinogenic lesions due to their rate of degeneration up to 20%. Causes hoarseness as a complaint. Surgical interventions aiming to improve the voice quality and open the respiratory passage are performed. There is no finalized treatment method. The most effective treatment method is vaporization of papilloma mass by CO2 laser. Furthermore, benefits of systemic interferon treatment are also reported.
Leucoplasias (whitish, thickened mucosal zones) and hyperceratoses (mucosal coarsening and thickening in colors changing from gray to red) are seen more frequently in smokers and chronic laryngitis. They macroscopically carry a malignity doubt, and should be examined histologically. These patients must at all times be kept under control due to malignity development risk.