Diagnosis
Benign vocal cord lesion
A benign lesion that occurs on the vocal cords. Most common cause of voice problems after acute laryngitis
Also known as: Benign vocal fold lesion, Reinke's edema, Screamer's nodes, Singer's nodes, Vocal cord nodules, Vocal polyps
Etiology
Cause - Laryngeal trauma
Voice abuse
Coughing or throat clearing
Persistent postnasal drip
Laryngopharyngeal reflux
Faulty singing technique
Allergy
URI, sinusitis
Smoking and alcohol
Pathophysiology [yir]
Polyp (53.7%)
Ulcer
Nodule (11.4%)
Cyst (13.3%)
Pseudocyst (16.7%)
Papilloma (HPV)
Epidemiology
Incidence per 100.000 [pa9][quv][6id][oyr][ku8][bp7]
Prevalence per 100.000 [pa9][quv][6id][oyr][ku8][bp7]
Symptoms & findings
Symptoms
Aphonia, Cough, Hoarseness, Stridor
Clinical findings
None listed.
Anamneses
None listed.
Localized findings
Approach
Laryngoscopy
Bronchoscopy
Treatment
Voice therapy is the primary treatment [yir]
Medical treatment: Reflux medication, stop smoking, good hydration, stop anticoagulants
Steroid injection
Surgery if nodule of any size with an unacceptable voice
Differential diagnoses
Acute laryngitis, Croup, Epiglottitis, Laryngeal cancer, Laryngopharyngeal reflux disease, Reinkes edema, Vocal cord immobility
References
[1] Wiktoria et al. Systematic Review of Recurrence Rates of Benign Vocal Fold Lesions Following Surgery, Journal of Voice, 2022.
[2] Soo Yeon Jung et al. Trends in the Incidence and Treatment of Benign Vocal Fold Lesions in Korea, 2006–2015: A Nationwide Population-based Study. Journal of Voice. Volume 34, Issue 1, 2020, Pages 100-104.
[3] Cohen et al. Prevalence and causes of dysphonia in a large treatment-seeking population. Laryngoscope. 2012 Feb;122(2):343-8.
[4] Hardianingwati et al (2020). Prevalence of Benign Vocal Fold Lesions in Ear, Nose, and Throat Outpatient Unit of Dr. Soetomo General Hospital, Surabaya, Indonesia. Biomolecular and Health Science Journal, 3(1), 37–40.
[5] Malik et al. The Clinicopathological Study of Benign Lesions of Vocal Cords. Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):212-220.
[6] Upadhyay et al. A Comprehensive Analysis of Benign Vocal Fold Lesions Causing Hoarseness of Voice and Our Experience with Cold Knife Endolaryngeal Surgery in a Tertiary Healthcare Centre. Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):515-521.
[7] Bhadesia et al. (2020). A descriptive study of benign vocal cord lesions. International Journal of Otorhinolaryngology and Head and Neck Surgery.
[8] Abdullah Alanazi et al. Recurrent Respiratory Papillomatosis: An Update. International Journal of Head and Neck Surgery. Volume 13 | Issue 1 | Year 2022.
[9] Zhukhovitskaya et al. Gender and age in benign vocal fold lesions. Laryngoscope. 2015 Jan;125(1):191-6.