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Vocal Cord Disorders

The vocal cords (also called vocal folds) are two bands of smooth muscle tissue located in the larynx (voice box). The larynx is located in the neck at the top of the trachea (windpipe). Vocal cords produce the sound of your voice by vibration and the air passing through the cords from the lungs. The sound the vocal cords produce is then sent through the throat, nose, and mouth, giving the sound "resonance." The sound of each individual voice is determined by the size and shape of the vocal cords and the size and shape of the throat, nose, and mouth (the resonating cavities).

Vocal cord disorders are often caused by vocal abuse or misuse, such as excessive use of the voice when singing, talking, smoking, coughing, yelling, or inhaling irritants. Some of the more common vocal cord disorders include laryngitis, vocal nodules, vocal polyps, and vocal cord paralysis.

Laryngitis is often characterized by a raspy or hoarse voice due to inflammation of the vocal cords. Laryngitis can be caused by excessive use of the voice, infections, inhaled irritants, or gastroesophageal reflux (the backup of stomach acid into the throat).

Vocal nodules are benign (noncancerous) growths on the vocal cords caused by vocal abuse. Vocal nodules are a frequent problem for professional singers. The nodules are small and callous-like and usually grow in pairs (one on each cord). The nodules usually form on areas of the vocal cords that receive the most pressure when the cords come together and vibrate (similar to the formation of a callous). Vocal nodules cause the voice to be hoarse, low, and breathy.

A vocal polyp is a soft, benign (noncancerous) growth, similar to a blister. Voice polyps cause the voice to be hoarse, low, and breathy.

Paralysis of the vocal cords may occur when one or both vocal cords or folds does not open or close properly. A common disorder, this condition can range from relatively mild to life-threatening. When one or both vocal cords are paralyzed, the open cord(s) allows food or liquids to slip into the trachea and lungs. A person may experience difficulty swallowing and coughing. Vocal cord paralysis may be caused by the following:

  • head, neck, or chest trauma
  • complication during surgery
  • stroke
  • tumor
  • lung or thyroid cancer
  • neurological disorders, such as multiple sclerosis or Parkinson's disease
  • viral infection

Treatment may include surgery and voice therapy. Sometimes, no treatment is necessary and a person recovers on his or her own.

How are vocal cord disorders diagnosed?

Any hoarseness or change in voice that lasts longer than two weeks should be brought to the attention of your doctor. (Sometimes the hoarseness may be indicative of laryngeal cancer.) In addition to a complete medical history and physical examination, the doctor may examine the vocal cords internally with a small scope called a laryngoscope. In the case of paralysis, your doctor may also perform a laryngeal electromyography that measures the electrical current in the vocal cords.

Treatment for vocal cord disorders

Vocal cord disorders caused by abuse or misuse are easily preventable. In addition, most disorders of the vocal cords can be reversed. Specific treatment for vocal cord disorders will be determined by your doctor based on:

  • your age, overall health, and medical history
  • extent and type of vocal cord disorder
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment may include any of the following:

  • resting the voice
  • eliminating the behavior that caused the vocal cord disorder
  • a referral to a speech-language pathologist who has specialized training in treating voice, speech, language, or swallowing disorders that affect communication
  • medication
  • surgery to remove growths