Vocal Cord Growths
Vocal cord growths or lesions are benign, but can affect the voice and cause hoarseness. They are typically a result of trauma or overuse of the vocals.
Vocal cord nodules usually result from overuse or incorrect use of the vocal cords. These small, callus-like growths develop in the middle of the vocal cords. Women between the ages of 20 and 50 are most prone to vocal cord nodules.
Vocal cord polyps can occur on one or both sides of the vocal cords. They can appear red in color and vary in shape and size, sometimes resembling blisters. Polyps can be caused from misuse or overuse of the vocal cords, or they can result from a single event (such as yelling or singing for a long time). Some other causes include muscle tension in the throat, alcohol consumption, smoking, allergies, sinusitis, and hypothyroidism. A certain type of polyp called polypoid corditis is exclusively associated with smoking.
Vocal cord cysts are characterized by the growth of a fluid-filled or firm sac on the vocal cords. Mucus retention cysts and Sebaceous cysts are the two forms this condition can take. Typically, voice therapy and surgery are required to remove a cyst.
Papillomas are small wart-like growths on the vocal cords caused by Human Papillomavirus, or HPV. These growths can cause hoarseness and other troubles with the voice, or even shortness of breath if the papilloma has grown significantly. They typically need surgery to be removed, which can be done in various minimally invasive ways.
Vocal Cord and Voice Box Cancers
Voice box or vocal cord cancers, also called laryngeal cancer is a serious condition of the throat. The larynx is the part of the throat that contains the voice box and the entrance to the trachea.
Symptoms of Vocal Cord and Voice Box Cancers
Some of the main symptoms of laryngeal cancers include:
- Difficulty swallowing
- Changes in voice
- Swelling or lump in neck/throat
- Sore throat
- Difficulty breathing
Causes of Vocal Cord and Voice Box Cancers
Risk of the condition is increased by:
- Exposure to carcinogens, such as asbestos or coal dust
- Unhealthy diet
- Family history of the disease
- Alcohol consumption
Procedures and Treatments for Vocal Cord and Voice Box Cancers
Depending on the type and severity of the cancer, the condition may require surgery. In late stage cancers, parts or all of the voice box may need to be removed and some reconstructive surgeries may be done. More commonly, laser surgery can be done to excise (remove) tumors on the larynx or to vaporize cancer cells. This approach gets rid of diseased cells and preserves the patient’s voice.
Hoarseness in Singers and Speakers
Hoarseness in singers and speakers is a symptom that is normally caused from overuse or misuse of the vocal cords, or in some cases, certain diseases of the voice box. Hoarseness becomes apparent from breathy, strained, or raspy sounds as well as changes in pitch or volume in the voice.
Causes of Hoarseness
In singers and speakers, misuse and overuse are the most common causes. Some other factors that can contribute to changes in voice are:
- Common cold or respiratory infection
- Gastroesophageal reflux
- Trauma to the voice box
The type of voice changes can help determine the condition causing the hoarseness.
- Breathy voice can suggest poor vocal cord function, the presence of a benign growth, or cancer of the larynx.
- Raspy voice can suggest thickening or swelling of the vocal cords, infection, voice abuse, or paralysis of the vocal cords.
- High, shaky, or quiet voice may indicate a lack of airflow or breathing force through the voice box.
Procedures and Treatments for Hoarseness
Your doctor will determine how to treat your voice changes. Rest and voice therapy may be recommended. It is always important to avoid or quit smoking. Surgery may be recommended if there is a growth or a functional issue with the vocal cords. These procedures are almost always performed with a minimally invasive approach.
Vocal Cord Paralysis or Weakness
Paralysis of the vocal cords occurs when nerve function to the voice box (larynx) are damaged. Paralyzed vocal cords can affect the ability to produce sound, breathing, and swallowing. Nerve damage, infection, or cancer can result in weakness or paralysis of the vocal cords.
Symptoms of Vocal Cord Paralysis and Weakness
Usually only one vocal cord is affected by paralysis. If both are paralyzed or weak, there may be serious inability to speak, breathe, or eat. Some symptoms of the condition are:
- Breathy voice
- Choking while eating
- Loss of vocal pitch
- Poor gag reflex
- Noisy breathing
- Frequent pausing for breath while talking
- Frequent throat clearing
- Quiet voice
Causes of Vocal Cord Paralysis and Weakness
Some causes of vocal cord weakness and paralysis include:
- Damage to vocal cords during surgery, sometimes from improper placement of a breathing tube
- Neck or chest trauma
- Viral infection
- Neurological conditions
- Tumors or growths
Procedures and Treatments for Vocal Cord Paralysis and Weakness
The treatment of the condition depends on the cause and severity of the symptoms. Sometimes voice therapy can strengthen the vocal cords enough to improve breath control and sound of voice. Most of the time, surgery or injection is the best option.
Vocal cord injections
Paralysis of the nerve to the vocal cord typically leaves the muscle thin and weak. Collagen, body fat, or other substances can be injected into the vocal cord to provide some bulk to the vocal cord, bringing it back into contact with the middle of the voice box.
Thyroplasty surgery to restore voice
A thyroplasty is a surgery that involves the implantation of a structural device in the larynx or the repositioning of the vocal cords. There are different approaches and types of implants for different varieties of the condition, but all result in better functioning vocal cords.
Spasmodic dysphonia is a neurological condition that affects the muscles of the larynx. Spasmodic dysphonia causes abrupt muscle movements called spasms that result in strains and breaks in the voice. This condition affects women more than men and persists throughout the lifespan if not treated. The condition can be difficult to diagnose since the symptoms are similar to other voice box disorders, but an otolaryngologist can distinguish the conditions with exams.
Treatment for Spasmodic Dysphonia
There is no cure for spasmodic dysphonia, but injections of botulinum toxin (Botox) into the vocal cords can drastically reduce the symptoms. The injection weakens the muscles by blocking nerve impulses, which reduces spasms. The effects of this treatment typically last around three to four months before symptoms gradually return. In order to maintain symptom free, reinjections will be necessary. In mild cases of spasmodic dysphonia, voice therapy may be able to treat the condition.
Difficulty Swallowing (Dysphagia)
Difficulty swallowing is called dysphagia. Dysphagia can indicate other serious medical conditions or it can be a result of stroke, nerve weakness, or other medical illnesses. It can occur at any age, but it is more common in older adults.
Symptoms of Difficult Swallowing
Signs associated with dysphagia are:
- Pain while swallowing
- Inability to swallow
- Sensation of food being stuck in throat or chest
- Frequent heartburn
- Unexpected weight loss
- Coughing or gagging when swallowing
Procedures and Treatments for Difficult Swallowing
Dysphagia can sometimes be treated by learning exercises that can strengthen and coordinate swallowing muscles, or by learning new swallowing techniques. Depending on the root of the issue, medications may be prescribed. For example, dysphagia as a result of gastroesophageal reflux disease (GERD) may go away if the reflux is controlled. More surgical approaches may be the best option. The esophagus can be dilated with a small balloon, or other endoscopic surgeries can repair damage in the throat or voice box.
This condition is characterized by the formation of a pouch in the upper esophagus that causes difficulty swallowing and regurgitation. Zenker’s diverticulum can cause food to get trapped in this extra pouch in the esophagus, which can lead to very bad breath and infection. This condition is rare and is almost always found in elderly patients. If you suspect you have Zenker’s diverticulum, it will be diagnosed with swallowing tests, like a barium swallow.
Procedures and Treatment for Zenker’s Diverticulum
If the diverticulum is large enough to cause symptoms, then it likely needs to be removed. There are several different ways to remove the pouch caused from the condition, including laser surgery or endoscopic stapling.