Vocal Fold Granuloma

Overview and Facts about Vocal Fold Granuloma

A vocal fold granuloma is a small area of inflammation on the vocal cords that occurs due to some type of irritation or injury.

They can be pale or sometimes red in color and grow on the cartilages that attach to the back of the vocal cords. These growths are noncancerous but may continue to grow if they are not treated.

Symptoms and Signs of Vocal Fold Granuloma

Symptoms of a vocal cord granuloma are most apparent while speaking, singing, breathing, and eating. Signs and symptoms can include:

• Problems speaking or singing
• Persistent pain when speaking and/or swallowing
• Hoarseness or breathiness in the voice
• A rough voice that tires easily
• The feeling of a lump in the throat
• A sore throat or a persistent tickle in the throat
• A dry cough or ear pain

Occasionally, a vocal fold granuloma will cause problems with breathing. If this is the case, seek medical attention immediately.

Tests and Diagnosis of Vocal Fold Granuloma

An otolaryngology specialist, or ENT doctor, can diagnose vocal cord granulomas by examining the back of the throat with a small video camera. Different diagnostic tests include:

• Flexible laryngoscopy: A flexible scope is inserted through the nose to look at the throat, pharynx and larynx. This study gives basic information regarding the form and function of the throat structures.
• Transnasal esophagoscopy (TNE): A flexible scope with a camera is inserted through an anesthetized nose and fed through the throat, into the esophagus and to the stomach. This screening tool is useful in evaluating the esophagus in patients with acid reflux, throat pain and swallowing symptoms

Causes and Risk Factors of Vocal Fold Granuloma

Everyone faces a risk for developing a vocal cord granuloma. The primary causes for vocal cord granulomas are irritation or injury to the vocal cords. This can happen as a result of:

• Using a breathing or feeding tube that is inserted in the throat
• Using an excessively loud speaking voice for an extended period of time
• Excessive coughing or chronic throat clearing
• Acid reflux

Treatment and Care for Vocal Fold Granuloma

Treatment usually begins with control of acid reflux with medications and changes in diet. If the granuloma persists despite conservative therapy, treatment with an in-office steroid injection and/or laser treatment may be beneficial.

If the granuloma is large or obstructs your breathing, surgical treatment could be required. Surgery could include removing the granuloma with lasers, injections of steroids and possibly injection of botulinum toxin (botox).