Vocal fold polyp

Polyps are benign masses on vocal fold tissue. Mostly unilateral (one-sided) and of various sizes.

They make up 12% of all voice pathologies. Prevalence rate is 4/1000.

Symptoms

• Hoarseness (mild to severe)
• Throat pain after a long use

The majority of polyps have a history of bleeding within the tissue. Blood accumulates inside the submucosal space and deforms the overlying tissue in time and create pathologies what we call polyps. If blood stays they would be called as hemorrhagic polyp.

Most pathologies look alike polyps even at an early stage cancer, therefore endoscopic high definition imaging with stroboscopy helps the diagnosis with more than 95% accuracy. High Speed Digital Imaging helps in pre-operative quantification of vibration disturbances caused by the polyp.

Large polyps can cause dyspnea. Removal is mandatory in such cases.

Underlying factors

• Voice overuse, misuse
• Laryngopharyngeal Reflux
• Medications Aspirin, diuretics, other medications resulting bleeding
• Rheumatoid arthritis
• Smoking - larger polyps called Reinke's edema or polypoid edema

Treatment

• Voice rest is the primary treatment especially in early cases (9.7% of vocal fold polyps might resolve without surgery.)
• Vocal hygiene
• Voice therapy - mostly improves voice. Effective on females with sessile polyps.
• Percutaneous steroid injection (complete or partial improvement in 2/3 of the patients. 24% recurrence)
• Cold microsurgery
• Laser microsurgery with CO2 laser, KTP or 585 nm pulsed dye laser.