Vocal Cord Polyps: Diagnosis, Treatment & Recovery

What are Vocal Cord Polyps?

Vocal cord polyps refer to benign (non-cancerous) growths that occur on the vocal cords. They typically cause hoarseness and a breathy voice, which can develop over days to weeks. Vocal cord polyps can significantly affect an individual’s quality of life due to changes in voice quality.

In India, vocal cord polyps affect a significant number of people each year. This condition tends to occur more commonly in individuals who use their voices excessively, like teachers, singers, and public speakers. However, anyone can experience them due to various underlying causes such as hormonal imbalances or exposure to inflammatory agents like smoke or allergens.

The healthcare system in India recognises the impact of these conditions on an individual’s daily life functions and therefore prioritises timely treatment to prevent complications and preserve voice quality. According to data available from Indian medical resources, vocal cord polyps are seen in both men and women across different age groups.

What Causes Vocal Cord Polyps?

Vocal cord polyps result from a combination of factors that cause irritation and inflammation in the vocal cords. Here are some key causes:

Long-term overuse of the voice: Frequently using the voice excessively or unnaturally, such as shouting, talking too much, or using an unnaturally low pitch, can lead to the development of polyps.

• Intense trauma to the voice: Sudden vocal injuries, such as shouting at a loud event, can cause polyps to form on one cord.
• Hypothyroidism: Untreated hypothyroidism can contribute to the formation of polyps.
• Allergies: Chronic allergic reactions can cause irritation and inflammation, that may lead to polyp formation.
• Smoking: Smoking is associated with a specific type of polyp known as polypoid corditis or Reinke’s edema.
• Gastroesophageal reflux disease (GERD): Chronic GERD can cause inflammation and irritation that may lead to polyp development.
• Side effects of certain medications: Some medications can cause vocal cord irritation leading to polyp formation.
• Hormonal imbalances: Changes in hormones can contribute to the development of polyps on the vocal cords.

Long-term exposure to toxic fumes: Regular inhalation of irritants such as industrial fumes can also lead to polyp formation.

Types of Vocal Cord Polyps

Vocal cord polyps are non-cancerous growths that can form on your vocal cords. These growths are usually harmless but may cause voice changes or difficulty speaking. Let’s examine some of the different types of vocal cord polyps:

• Pedunculated Polyps: These are attached to the vocal cords by a thin stalk. They are typically large and may need surgical removal.
• Polypoid Edema: This kind of polyp results from chronic irritation and inflammation, leading to swelling and thickening of the vocal cord tissue.

Reinke’s Edema: This type of polyp is often associated with smoking. It is characterised by swelling and thickening of the vocal cord tissue.

Symptoms of Vocal Cord Polyps

The signs and symptoms of vocal cord polyps, or throat polyps, can vary largely, but tend to most commonly include:

• A strained or breathy voice: You might feel like you’re straining your voice even when speaking normally.
• Hoarseness: Your voice might have a rough, scratchy quality.
• Voice cracking: You might find that your voice cracks or is delayed when you begin to speak.
• Extra effort needed to speak or sing: Speaking or singing might need more effort than it usually does.
• Frequent throat clearing: You might feel a constant need to clear your throat.

Feeling that there’s something stuck in your throat: This could be accompanied by pain from ear to ear.

Diagnosis and Evaluation of Vocal Cord Polyps

The diagnosis of vocal cord polyps primarily involves direct or indirect visualisation of the larynx using either a mirror or a laryngoscope. This allows doctors to get a clear view of the vocal cords and identify any abnormal growths.

In some cases, additional testing may be required, such as a biopsy. This involves taking a small sample of tissue from the affected area for further examination. A biopsy is crucial to rule out more serious conditions such as cancer.

Both these techniques allow for a comprehensive evaluation of the condition, aiding in determining the best course of treatment.

How Vocal Cord Polyps Can be Treated?

Treatment for vocal cord polyps tends to vary based on the severity and cause of the condition. Here are some common treatments:

• Avoiding the irritating cause: This could involve avoiding smoking or managing gastroesophageal reflux disease (GERD), which are both common causes of vocal cord polyps.
• Surgical removal: Most polyps may need to be surgically removed to restore normal voice function. This is often done in an operation theatre (OT) by a specialist.
• Speech therapy: Following surgery, you might need speech therapy to learn how to avoid straining your vocal cords when speaking or singing.
• Resting the voice: Avoiding excessive use of your voice can help alleviate symptoms and aid in recovery.

Laser treatments: Laser treatments are used for vocal cord papillomas, non-cancerous warty growths caused by certain human papillomaviruses (HPVs).

When are Vocal Cord Polyps Considered Serious?

Vocal cord polyps are not usually seen as a serious health condition. However, they can sometimes become problematic in certain scenarios:

• Airway Obstruction: Rarely, large polyps may grow sufficiently to partially block one’s airway, creating breathing difficulties. This is more typically associated with vocal cord papillomas in children.
• Recurrence after Treatment: If the root cause of the polyps isn’t adequately addressed, they might recur even following surgical removal, which can greatly frustrate patients.
• Malignant Transformation: A small risk exists that a polyp might turn into a cancerous growth. This risk is amplified in smokers and those with a history of head and neck cancer.

Impact on Voice and Communication: Polyps can lead to voice changes like hoarseness or breathiness that may seriously affect a person’s communication capabilities, especially if they use their voice professionally.

Prevention of Vocal Cord Polyps

Given that vocal cord polyps result from a variety of factors, including vocal strain, reflux, allergies and hormonal changes, complete prevention might not always be possible. However, risk reduction certainly is. Avoiding vocal abuse by moderating one’s voice use, maintaining good hydration and pursuing a healthy lifestyle can all help reduce the likelihood of developing polyps. Those suffering from reflux or allergies should seek appropriate medical treatment. Regular check-ups with an ENT (Ear, Nose and Throat) specialist can also provide early detection and prevention of complications.

Myths & Facts About Vocal Cord Polyps

Let’s debunk some common misconceptions about vocal cord polyps:

Myth: Vocal cord polyps are cancerous growths.

Fact: Almost always, vocal cord polyps are benign.

Myth: Only elderly individuals suffer from vocal cord polyps.

Fact: People of all ages, from children to adults, can develop vocal cord polyps.

Myth: Vocal cord polyps are permanent and untreatable.

Fact: Proper treatment can often successfully address vocal cord polyps, although recurrence is possible if the underlying cause isn’t resolved.

Myth: Excessive yelling or shouting is the sole cause of vocal cord polyps.

Fact: While vocal abuse can lead to polyp formation, other factors like reflux, allergies and hormonal changes also play a role.

When to Consult a Doctor for Vocal Cord Polyps?

If you’re experiencing persistent hoarseness, voice changes, or breathing difficulties, it’s important to seek medical advice. Consult with an ENT specialist who can correctly diagnose your condition and present the right treatment options. Timely intervention can prevent vocal cord polyps from potentially evolving into a serious problem.

Questions to Ask Your Doctor About Vocal Cord Polyps

Here are some questions you might wish to discuss with your doctor:

1. What are the main symptoms of vocal cord polyps?
2. What causes vocal cord polyps to develop?
3. How are vocal cord polyps diagnosed?
4. What treatment options do I have for my vocal cord polyps?
5. How effective is surgery in removing vocal cord polyps?
6. Can vocal cord polyps recur after treatment?
7. Are there any long-term complications associated with vocal cord polyps?
8. Can these polyps affect my singing or speaking voice?
9. Are there any known risk factors for developing vocal cord polyps?

10. What lifestyle changes can I make to minimise my risk of developing vocal cord polyps?