Vocal fold polyp
General
As vocal fold polyps (or also Vocal cord polyps) is a benign change (a benign tumor) located on the vocal cord.
These polyps always arise on the free edge of the vocal fold or on the subglottic Departure (corresponds to the area under the glottis) of the anterior third of the vocal fold. In most cases, a vocal fold polyp is located at the transition from the anterior to the middle third. About 90% of people have a vocal fold polyp on only one side.
Appearance of vocal cord polyps
Vocal cord polyps can look very different.
You are either
- reddish and vascular (you can sometimes see small bluish veins running in the polyp, which you then telangiectatic calls) or
- glassy translucent, in which case one is also from one Gelatinous polyps speaks.
Vocal cord polyps can also vary greatly in size. Mostly they are rather small and broad-based on the vocal fold, but there are also larger polyps that are spherical and pedunculated.
So far, no malignant degeneration of benign vocal cord polyps has been described. When examining a vocal cord polyp under a microscope (a histological Examination), then you can see an enlargement of the tissue, which is caused by an increase in the number of cells (Hyperplasia) comes about. This hyperplasia affects the lining of the lining and is the response to inflammation. It can either have an angioma- or a fibroma-like structure or it can be a real fibroma (benign tumor).
Causes of emergence
Why it for Emergence of a vocal fold polyp can still occur today not clarified become.
It is noticeable, however, that they accumulate at Men in the middle age occur. Besides, there seem to be more Risk factors to give:
- the Smoke of cigarettes
- a lasting strong burden the voice (as it occurs, for example, with teachers or singers)
Symptoms
Patients with a vocal fold polyp usually fall through one hoarseness on. This hoarseness can either permanent exist or only at times occur. This is especially the case if the vocal cord polyp is built to move depending on the position the vocal folds can shift.
So it is with bigger Polyps, for example, may be in the area under the glottis "slip“Cannot and in this position cause no complaints. With this type of polyp, the hoarseness usually disappears after one to cough or Clear throat. Especially, but not exclusively, with such patients there is often a Coughing force in front. In addition, a so-called Diplophony exist, so one Dual tone the vocal sound.
Some patients also describe a Foreign body sensation in the throat, which, like hoarseness, can decrease and increase in intensity and is either permanent or only intermittent. The larger an existing vocal fold polyp, the more likely it is to be one more or less restricted breathing up to one Choking attack come.
Diagnosis
A vocal cord polyp is diagnosed with the help of a Larynxoscopy (Laryngoscopy), for which the ENT specialist Vocal folds and the Glottis directly or indirectly consider and judge can.
A vocal fold polyp then offers him the typical findings described above. With smaller polyps, however, it is sometimes difficult to remove them Vocal cord nodules or Vocal cord cysts to differentiate. These are other important differential diagnoses Contact- and the Intubation granuloma, which is a nodular, inflammation-related Tissue formation represent.
Treatment of vocal cord polyps through surgery
Although no danger for one malicious If there is degeneration of a vocal fold polyp, these changes are due to their symptoms surgically removed.
This removal takes place microsurgical during a direct or indirect Laryngoscopy (Larynxoscopy), whereby the direct laryngoscopy is preferred because it is gentler on the Vocal fold is. The surgical laryngoscope is inserted through the mouth and the polyp can be manipulated with the help of small instruments (such as a double spoon or small forceps) or a Laser device removed. This surgery is usually under general anesthetic performed by a specialized phonosurgeon can rarely have a polyp removal local anesthesia respectively.
In order to confirm the diagnosis, the removed tissue is followed in each case histologically examines, which means that the tissue is specially assessed under the microscope. After a successful procedure, the patient is cured and the symptoms are gone. A renewed vocal fold polyp (relapse) only occurs in very few exceptions.
Risks of the operation
Since the removal of the vocal fold polyp is a minor procedure, complications only occur Rare on. However, like any other procedure, the microsurgical removal of the vocal fold polyp carries risks.
It can be during and after surgery too Bleeding come. Also are difficulties swallowing not infrequently, as there are small injuries to the mucous membranes. Pain after the procedure, which should go away after a few days, rarely occur. Another risk that occurs in almost all patients after a vocal cord polyp removal is that hoarseness. This can be through a possible Swelling of the vocal folds in some cases persist for up to four weeks after surgery. Very rarely does the area where the polyp was removed become inflamed. If bacteria have got into the wound, one must Antibiotic treatment be treated.
Follow-up treatment after the operation
After endoscopic removal of the vocal fold polyp, patients should be asked for not speaking for three days. If it is necessary, it should whispered language can be dispensed with, as whispering puts more stress on the vocal folds. Patients should speak at a normal volume. If secondary bleeding occurs, a doctor should be consulted. Also should Avoid hot and spicy food for about a week. Smokers should also Quit smoking for at least a week - preferably longer, as cigarette smoke negatively affects and slows down wound healing.
Speech therapy
The sound of the voice is often impaired after the vocal fold polyp has been removed. For this reason, speech therapy, speech and voice training is recommended for most patients after the procedure, in which language is trained again.
These speech therapy exercises should be started as early as possible so that the muscles that are important for speech do not regress. After successfully completing the voice training, most patients' voices are as they were before the procedure.
Read more about this at: Speech therapy
