Anatomy of Vocal Cord

The vocal cords are two bands of muscle tissue covered by a mucosal lining, which vibrate to produce sound. The vocal cords (or vocal folds) are located within the larynx (voice box) at the top of the trachea.

Physiology of Vocal Cord

• Sound Production: When air passes through the vocal cords, they vibrate to create sound. The pitch and volume are adjusted by changes in tension and airflow.
  
• Role in Breathing and Swallowing: Vocal cords also help protect the airway during swallowing and open widely for breathing.
  

Lesions of Vocal Cords

Causes: Lesions can result from vocal strain, trauma, smoking, infections, or acid reflux. Some may develop from viral infections, such as HPV.

• Benign Lesions: Includes polyps, nodules, cysts, and Reinke’s edema.
  
• Malignant Lesions: Laryngeal cancer, often associated with smoking and HPV.
  

Benign Lesions of the Vocal Cords

• Vocal Cord Polyps Reddish, swollen, fluid-filled growths usually affecting one vocal cord. Often due to acute vocal trauma or chronic irritation from smoking or reflux.
  
• Vocal Cord Nodules Small, callus-like bumps on both vocal cords. Result from chronic vocal strain, often seen in professional voice users.
  
• Vocal Cord Cysts Whitish or yellowish bumps within the vocal cords. Blocked mucus glands or trauma; can be congenital or acquired.
  

Symptoms

• Hoarseness: Common in all types of lesions, presenting as a rough, breathy, or raspy voice.
  
• Vocal Fatigue: Patients often feel strain and fatigue, especially after speaking or singing for long periods.
  
• Other Symptoms: Persistent sore throat, difficulty swallowing, and, in cases of cancer, pain or difficulty breathing.
  

Diagnosis

• Endoscopy/Laryngoscopy: A primary diagnostic tool using a flexible or rigid scope to visualize the vocal cords directly.
  
• Biopsy: Performed during endoscopy if malignancy is suspected, providing tissue samples for analysis.
  
• Imaging: CT or MRI may be used for deeper or suspected malignant lesions to assess extent and staging.
  

Treatment

Endoscopic laryngeal surgery is a minimally invasive procedure used to diagnose and treat various disorders of the vocal cords and larynx. By employing an endoscope—a thin, flexible tube with a light and camera—surgeons can access and operate on the larynx through the mouth without any external incisions. This approach is highly effective for treating vocal cord lesions, benign tumors, and early-stage cancers, allowing patients to preserve vocal quality while reducing recovery time and lower risk of complications. Post Operative Care Vocal rest is essential immediately after surgery, followed by gradual reintroduction of voice use. Smoking cessation, managing acid reflux, and avoiding irritants like alcohol and excessive caffeine are critical for preventing lesion recurrence.