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Vocal Cord Contact Ulcers

By Clarence T. Sasaki, MD, The Charles W. Ohse Professor of Surgery and Director, Yale Larynx Lab, Yale University School of Medicine

Vocal cord contact ulcers are raw sores on the mucous membrane covering the cartilage to which the vocal cords are attached.

Vocal cord contact ulcers are usually caused by abusing the voice with forceful speech, particularly as a person starts to speak. These ulcers typically occur in singers, teachers, preachers, sales representatives, lawyers, and other people whose occupation requires them to talk or otherwise use their voice a lot.

Backflow (gastroesophageal reflux[GERD]) of stomach acid also may cause or aggravate vocal cord contact ulcers.

Endotracheal intubation (insertion of a plastic breathing tube through the mouth or nose into the windpipe [trachea]) may cause vocal cord contact ulcers if the tube is too big.

Did You Know...

  • Gastroesophageal reflux can cause ulcers to grow near the vocal cords.

Symptoms include mild pain while speaking or swallowing and varying degrees of hoarseness.


  • Direct inspection with a viewing tube

  • Occasionally biopsy

A doctor makes the diagnosis by examining the vocal cords with a thin, flexible viewing tube (laryngoscopy).

Occasionally, a small tissue sample is removed and examined under a microscope (biopsy) to make sure that the ulcers are not cancerous (malignant) and are not caused by tuberculosis.


  • Resting the voice

  • Voice therapy

  • For gastroesophageal reflux, taking antacids, not eating near bedtime, and elevating the head in bed

  • Antibiotics

Treatment involves resting the voice by talking as little as possible for at least 6 weeks so that the ulcers can heal. Whispering may cause further injury and must also be avoided.

To avoid recurrences, people who develop contact ulcers need voice therapy to learn how to use the voice properly. A speech therapist can provide such instruction.

If the person has gastroesophageal reflux, treatment includes taking antacids, not eating within 2 hours of retiring for the night, and keeping the head elevated while sleeping.

Antibiotics can help prevent bacterial infections while the ulcers are healing.

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