Overview and Facts about Vocal Fold Scarring
Vocal fold scarring occurs when scar tissue forms on the vocal cords which vibrate to create the sound of a person’s voice. The scarring may range from mild to severe and may cover just one area or the entire set of vocal cords.
Once vocal fold scarring has occurred, it can cause a range of problems with the voice, including decreasing the vocal cords’ ability to vibrate and causing issues with speaking and singing.
Symptoms and Signs of Vocal Fold Scarring
When scars develop on the vocal folds, it often results in a change in the sound of the voice and makes it difficult to speak or sing. Patients may sound horse or breathy and may have a “rough” quality to their voice.
Those with vocal cord scarring may also experience weakness in their voice or discover that it quickly tires when singing or talking excessively.
Tests and Diagnosis of Vocal Fold Scarring
Ear, nose, and throat (ENT) specialists diagnose vocal fold scarring by looking at the back of the throat with a videostroboscope, which evaluates the vocal cords and their vibratory characteristics under magnification.
Some of the diagnostic tests your doctor may use include:
- Videostroboscopy: A flexible scope with a camera is inserted through the nose and fed into the larynx to visualize the vocal cords. A strobe light makes the vocal cords appear in slow motion and the examination is recorded. This study diagnoses and evaluates in detail the anatomy, physiology and any pathology of the vocal cords.
- Acoustic Analysis: Computer evaluation of multiple features of your voice assists in the diagnosis and treatment of your voice disorder. These measurements also serve as a way to objectively evaluate the progress that is made during and after treatments.
Causes and Risk Factors of Vocal Fold Scarring
Most of the time, vocal fold scarring occurs after an injury. These injuries can result from:
- Wear and tear on the vocal folds
- Using the voice a lot over time
- Misusing the voice by utilizing a bad singing technique or speaking forcefully
- Abusing the voice by screaming or yelling loudly
- Surgical repair of the vocal cords
- Trauma to the vocal folds
For those who have other otolaryngology issues, such as acid reflux or laryngitis, vocal fold scarring becomes more of a risk.
Treatment and Care for Vocal Fold Scarring
The first stage of vocal fold scarring treatment is voice therapy, a patient-centered treatment method that attempts to modify behaviors and vocal techniques that contribute to abnormal voicing.
Loyola's singing voice specialist has additional training and experience in rehabilitating injured singing voices. Voice and singing exercises will vary depending on the specific pathology being treated. Treatments are generally four to six sessions weekly.
When voice therapy isn’t enough to fix the voice, surgery may be the best option.
One surgical treatment option may be a direct microlaryngoscopy, which uses high-powered microscopes, microinstruments and various lasers (KTP, CO2) to remove masses, lesions, tumors, cancers, polyps, scar tissue or cysts. This precise method minimizes damage to normal tissue while optimizing removal of diseased tissue.
However, surgical approaches cannot fix all the problems associated with vocal cord scarring. Patients may still suffer from some voice limitations.
