Vocal cord nodules and polyps are noncancerous (benign) growths that cause hoarseness and a breathy voice.

Vocal Cord Problems When relaxed, the vocal cords normally form a V-shaped opening that allows air to pass freely through to the trachea. The cords open when air is drawn into the lungs (inspiration) and close during swallowing or speech. Holding a mirror in the back of a person's mouth, a specially trained doctor can often see the vocal cords and check for problems, such as contact ulcers, polyps, nodules, paralysis, and cancer. All of these problems affect the voice. Paralysis may affect one (one-sided) or both vocal cords (two-sided—not shown).

Vocal cord polyps are often the result of an acute injury (such as from shouting at a football game) and typically occur on only one vocal cord. Vocal cord nodules occur on both vocal cords and result mainly from abuse of the voice (habitual yelling, singing, or shouting or using an unnaturally low frequency).

Symptoms include chronic hoarseness and a breathy voice, which tend to develop over days to weeks. A doctor makes the diagnosis by examining the vocal cords with a thin, flexible viewing tube. Sometimes the doctor removes a small piece of tissue for examination under a microscope (biopsy) to make sure the growth is not cancerous (malignant).

Treatment is to avoid whatever is irritating the larynx and rest the voice. If abuse of the voice is the cause, voice therapy conducted by a speech therapist may be needed to teach the person how to speak or sing without straining the vocal cords. Most nodules go away with this treatment, but most polyps must be surgically removed to restore the person's normal voice.

Last full review/revision July 2008 by Clarence T. Sasaki, MD