Overview of Vocal Cord Nodules

Diagnosing 3 Major Types

Updated on November 01, 2021

Medically reviewed by John Carew, MD

Vocal cord nodules, also known as vocal fold cysts, are noncancerous growths that generally develop when a person somehow misuses or overuses their voice. The incidence of vocal fold nodules is unknown but the incidence is much higher among individuals who use their voices as part of their profession.

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In addition to nodules, polyps (an overgrowth of tissue that usually arises from a mucous membrane) and cysts (an undefined mass of tissue that is usually not cancerous) can also form on vocal cords.

Sometimes there is vocal cord thickening on the opposite side of the growth. Allergies and other irritants such as reflux laryngitis can also contribute to the formation of abnormal growths on the vocal cords.

Types of Vocal Cord Cysts

Three major types of cysts are commonly found on the vocal cords. Mucous retention cysts, are filled with clear fluid and originate from cells lining the respiratory tract. Poor voice hygiene is often the cause of mucous retention cysts. Epidermoid cysts, or squamous inclusion cysts, are made of epidermal (skin) cells and keratin. Epidermoid cysts most typically are caused by vocal cord abuse or excessive hard coughing. Oncocytic cysts, or salivary gland epithelial cysts, are rare and most commonly due to age.

Symptoms

Vocal cord cysts have a variety of symptoms which are unique to each individual. Some individuals with vocal cord cysts may experience the following symptoms:

hoarseness
pain
fatigue
a sudden loss of voice
difficulty singing at a certain pitch

Diagnosis of Vocal Cord Cysts

The diagnosis of vocal cords can be performed by laryngoscopy with a special light called a stroboscope, also known as videostroboscopy. This will allow your otolaryngologist to visually check your vocal cords and determine the impact the cyst has on the vocal cord's vibrations. Prior to any major treatment, your physician is likely to recommend voice rest and then repeat the laryngoscopy in order to visualize any changes that occurred while resting your voice.

Treatment

The first treatment is actually just a removal of instigating risk factors. Voice rest will help, while proper voice hygiene can be taught by a speech therapist specializing in voice therapy. Often, speech therapy is beneficial. Speech therapists can teach you ways to reduce vocal cord abuse and use your voice more efficiently. Surgery is reserved for cases where your voice is significantly impacted and is not usually a first-line treatment.

2 Sources

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Won SJ, Kim RB, Kim JP, Park JJ, Kwon MS, Woo SH. The prevalence and factors associate with vocal nodules in general population: Cross-sectional epidemiological study. Medicine (Baltimore). 2016;95(39):e4971. doi:10.1097/MD.0000000000004971
Vasconcelos D, Gomes AOC, Araújo CMT. Vocal Fold Polyps: Literature Review. Int Arch Otorhinolaryngol. 2019;23(1):116–124. doi:10.1055/s-0038-1675391

Additional Reading

Cipriani, N.A., Martin, D.E., Corey, J.P., Portugal, L., Caballero, N., Lester, R., ... Taxy, J.B. (2011). The clinicopathologic spectrum of benign mass lesions of the vocal fold due to vocal abuse. Int J Surg Pathol. 19(5):583-7. doi:10.1177/1066896911411480.
American Academy of Otolaryngology - Head and Neck Surgery. Fact Sheet: Nodules, Polyps, and Cysts.
Cardesa, A. & Slootweg, P.J. (2006). Pathology of the Head and Neck. Springer Science & Business Media. New York.
Schweinfurth, J. & Meyers, A.D. (2014). Vocal Fold Cysts.