International Journal of Head and Neck Surgery

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  14 (2023)
Volume  13 (2022)
Volume  12 (2021)
Volume  11 (2020)
Volume  10 (2019)
Volume  9 (2018)
Volume  8 (2017)
Volume  7 (2016)
Volume  6 (2015)
Volume  5 (2014)
Volume  4 (2013)
Volume  3 (2012)
Volume  2 (2011)
Volume  1 (2010)
Related articles

VOLUME 12 , ISSUE 4 ( October-December, 2021 ) > List of Articles

Invited Review Articles

Phonotraumatic Lesions

Vani K Gupta, Trishna Chitnis, Asitama Sarkar

Keywords : Mucosal bridge, Phonotrauma, Reactive vocal fold lesion, Sulcus, Varices, Vocal fold nodules, Vocal fold polyp

Citation Information : Gupta VK, Chitnis T, Sarkar A. Phonotraumatic Lesions. Int J Head Neck Surg 2021; 12 (4):131-143.

DOI: 10.5005/jp-journals-10001-1512

License: CC BY-NC 4.0

Published Online: 21-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Phonotraumatic lesions causing a voice change are a common finding in ENT practice. Many lesions have been described in literature. Each lesion has its own etiopathogenesis, clinical symptoms, stroboscopy findings and treatment modalities. In this chapter, we describe the etiopathogenesis and management of some of these common phonotraumatic lesions—vocal fold nodules, polyp, vascular lesions, vocal fold cyst, pseudocysts, reactive lesions, contact granuloma, sulcus vocalis and mucosal bridge.

HTML PDF Share
  1. Hochman I, Sataloff RT, Hillman RE, et al. Ectasias and varices of the vocal fold: clearing the striking zone. Ann Otol Rhinol Laryngol 1999;108(1):10–6.
  2. Altman KW. Vocal fold masses. Otolaryngol Clin North Am 2007;40(5):1091–1108.
  3. Roychoudhury A. Nodules and polyps. In: Nerurkar NK, Roychoudhary A, editors. Textbook of Laryngology. First. Jaypee Brothers Medical Publishers Ltd; 2017. p. 147–154.
  4. Gray SD, Smith ME, Schneider H. Voice disorders in children. Pediatr Clin North Am 1996 Dec;43(6):1357–1384.
  5. Jiang JJ, Diaz CE, Hanson DG. Finite element modeling of vocal fold vibration in normal phonation and hyperfunctional dysphonia: implications for the pathogenesis of vocal nodules. Ann Otol Rhinol Laryngol 1998;107(7):603–610.
  6. Hsiung M-W. Videolaryngostroboscopic observation of mucus layer during vocal cord vibration in patients with vocal nodules before and after surgery. Acta Otolaryngol 2004;124(2):186–191.
  7. Roy N, Bless DM, Heisey D. Personality and voice disorders: a multitrait-multidisorder analysis. J Voice 2000;14(4):521–548.
  8. Yano J, Ichimura K, Hoshino T, et al. Personality factors in pathogenesis of polyps and nodules of vocal cords. Auris Nasus Larynx 1982;9(2):105–110.
  9. Nerurkar NK, Kapre GM, Kothari NN. Correlation between personality type and vocal pathology: A nonrandomized case control study. Laryngoscope 2016;126(9):2063–2066.
  10. Kuhn J, Toohill RJ, Ulualp SO, et al. Pharyngeal acid reflux events in patients with vocal cord nodules. Laryngoscope 1998;108(8 Pt 1): 1146–1149.
  11. Ruiz DMCF, Pontes P, Behlau M, et al. Laryngeal microweb and vocal nodules. Clinical study in a Brazilian population. Folia Phoniatr Logop 2006;58(6):392–399.
  12. Benninger MS, Jacobson B. Vocal nodules, microwebs, and surgery. J Voice 1995;9(3):326–331.
  13. Courey MS, Shohet JA, Scott MA, et al. Immunohistochemical characterization of benign laryngeal lesions. Ann Otol Rhinol Laryngol 1996;105(7):525–531.
  14. Gray SD, Pignatari SS, Harding P. Morphologic ultrastructure of anchoring fibers in normal vocal fold basement membrane zone. J Voice 1994;8(1):48–52.
  15. Karkos PD, McCormick M. The etiology of vocal fold nodules in adults. Curr Opin Otolaryngol Head Neck Surg 2009;17(6):420–423.
  16. Aronson AE, Bless DM. Clinical Voice Disorders. Fourth. New York: Thieme Medical Publishers; 2009. p.174–175.
  17. Martins RHG, Defaveri J, Custódio Domingues MA, et al. Vocal fold nodules: morphological and immunohistochemical investigations. J Voice 2010;24(5):531–539.
  18. Dikkers FG, Nikkels PG. Benign lesions of the vocal folds: histopathology and phonotrauma. Ann Otol Rhinol Laryngol 1995;104(9 Pt 1):698–703.
  19. Vaughan CW. Current concepts in otolaryngology: diagnosis and treatment of organic voice disorders. N Engl J Med 1982 30;307(14):863–866.
  20. Leonard R. Voice therapy and vocal nodules in adults. Curr Opin Otolaryngol Head Neck Surg 2009;17(6):453–457.
  21. Sataloff RT, Chowdhury F, Portnoy JE, et al. Surgical techniques in otolaryngology—head and neck surgery: laryngeal surgery. First. Sataloff RT, editor. New Delhi: Jaypee Brothers Medical Publishers Ltd; 2014. 71 p.
  22. Alegria R, Freitas SV, Manso MC. Is there an improvement on acoustic voice parameters in patients with bilateral vocal fold nodules after voice therapy? a meta-analysis. Eur Arch Otorhinolaryngol 2020;277(8):2163–2172.
  23. Béquignon E, Bach C, Fugain C, et al. Long-term results of surgical treatment of vocal fold nodules. Laryngoscope 2013;123(8):1926–1930.
  24. Murry T, Woodson GE. A comparison of three methods for the management of vocal fold nodules. J Voice 1992;6(3):271–276.
  25. Mortensen M, Woo P. Office steroid injections of the larynx. Laryngoscope 2006;116(10):1735–1739.
  26. Kleinsasser O. Pathogenesis of vocal cord polyps. Ann Otol Rhinol Laryngol 1982;91(4):378–381.
  27. Wang C Te, Huang TW, Liao LJ, et al. Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy. JAMA Otolaryngol - Head Neck Surg 2013;139(6):610–616.
  28. Rosen CA, Simpson BC. Surgical management of vocal fold vascular lesions. In: Operative techniques in laryngology. Springer; 2008. p. 135–139.
  29. Postma GN, Courey MS, Ossoff RH. Microvascular lesions of the true vocal fold. Ann Otol Rhinol Laryngol 1998;107(6):472–476.
  30. Hirano S, Yamashita M, Kitamura M, et al. Photocoagulation of microvascular and hemorrhagic lesions of the vocal fold with the KTP laser. Ann Otol Rhinol Laryngol 2006;115(4):253–259.
  31. Zeitels SM, Akst LM, Burns JA, et al. Pulsed angiolytic laser treatment of ectasias and varices in singers. Ann Otol Rhinol Laryngol 2006;115(8):571–580.
  32. Nerurkar NK, Shukla SC. Subepithelial vocal fold cyst: a pearl on a string? Int J Phonosurgery Laryngol 2012;2(2):53–56.
  33. El-Hifnawi H, El-Hifnawi E. Light and electron microscopical studies of the anatomical and functional distribution of glands in human vocal cords. Arch Otorhinolaryngol 1984;240(3):277–285.
  34. Nerurkar NK, Chitnis T, Gupta VK, et al. A 10-year study of the etiopathogenesis of cysts with a study of seromucinous glands in vocal folds. Laryngoscope 2020;130(4):986–991.
  35. Monday LA, Cornut G, Bouchayer M, et al. Epidermoid cysts of the vocal cords. Ann Otol Rhinol Laryngol 1983;92(2 Pt 1):124–127.
  36. Shvero J, Koren R, Hadar T, et al. Clinicopathologic study and classification of vocal cord cysts. Pathol Res Pract 2000;196(2):95–98.
  37. Nerurkar NK, Shedge AE, Gupta HK, et al. Role of Narrow Band Imaging in Relation to Stroboscopy and White Light Laryngoscopy in Diagnosis of Benign Nonvascular Glottic Lesions. Int J Phonosurg Laryngol 2017;7(1):1–5.
  38. Kirke DN, Sulica L. The natural history of vocal fold cysts. Laryngoscope 2020;130(9):2202–2207.
  39. Sataloff RT, Hawkshaw MJ, Divi V, et al. Voice surgery. Otolaryngol Clin North. 2007;40(5):1151–1183, ix.
  40. Rosen CA, Simpson CB. Vocal fold cyst and vocal fold fibrous mass. In: Operative techniques in laryngologyechniques in Laryngology. Springer; 2008. p. 109–112.
  41. Koufman JA, Belafsky PC. Unilateral or localized Reinke's edema (pseudocyst) as a manifestation of vocal fold paresis: the paresis podule. Laryngoscope 2001;111(4 Pt 1):576–580.
  42. Newman SR, Butler J, Hammond EH, et al. Preliminary report on hormone receptors in the human vocal fold. J Voice 2000;14(1):72–81.
  43. Narbaitz R, Stumpf WE, Sar M. Estrogen target cells in the larynx: autoradiographic studies with 3H-diethylstilbestrol in fetal mice. Horm Res 1980;12(2):113–117.
  44. Estes C, Sulica L. Vocal fold pseudocyst: Results of 46 cases undergoing a uniform treatment algorithm. Laryngoscope 2014;124(5):1180–1186.
  45. Estes C, Sulica L. Vocal fold pseudocyst: A prospective study of surgical outcomes. Laryngoscope 2015;125(4):913–918.
  46. Rosen CA, Gartner-Schmidt J, Hathaway B, et al. A nomenclature paradigm for benign midmembranous vocal fold lesions. Laryngoscope 2012;122(6):1335–1341.
  47. Titze IR. Mechanical stress in phonation. J Voice 1994;8(2):99–105.
  48. Titze IR, Svec JG, Popolo PS. Vocal dose measures: quantifying accumulated vibration exposure in vocal fold tissues. J Speech Lang Hear Res 2003;46(4):919–932.
  49. Verdolini K, Rosen CA, Branski RC, editors. Classification Manual for Voice Disorders-1. First. Lawrence Erlbaum Associates; 2006. p 52–53.
  50. Johns MM. Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Curr Opin Otolaryngol Head Neck Surg 2003;11(6):456–461.
  51. Cho J-H, Choi Y-S, Joo Y-H, et al. Sun D-II. Clinical significance of contralateral reactive lesion in vocal fold polyp and cyst. J Voice 2018;32(1):109–115.
  52. Rosen CA, Lombard LE, Murry T. Acoustic, aerodynamic, and videostroboscopic features of bilateral vocal fold lesions. Ann Otol Rhinol Laryngol 2000;109(9):823–828.
  53. Koss SL, Kidwai SM, Pitman MJ. Contralateral Vocal Fold Reactive Lesions. Otolaryngol Neck Surg 2016;154(6):1079–1083.
  54. Radia SB, Nerurkar NK. Multimodality treatment for the contact granuloma of the vocal folds. Int J Phonosurgery Laryngol. 2018;8(1):46–51.
  55. Farwell DG, Belafsky PC, Rees CJ. An endoscopic grading system for vocal process granuloma. J Laryngol Otol 2008;122(10): 1092–1095.
  56. Fechner RE, Cooper PH, Mills SE. Pyogenic granuloma of the larynx and trachea: a causal and pathologic misnomer for granulation tissue. Arch Otolaryngol 1981;107(1):30–32.
  57. Garnett JD. Contact granulomas [Internet]. 2018. Available from: https://emedicine.medscape.com/article/865924-overview
  58. Rimoli CF, Martins RHG, Catâneo DC, et al. Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis. Braz J Otorhinolaryngol 2018;84(6):781–789.
  59. Dailey SH, Ford CN. Surgical management of sulcus vocalis and vocal fold scarring. Otolaryngol Clin North Am 2006;39(1):23–42.
  60. Arnold GE. Dysplastic dysphonia: minor anomalies of the vocal cords causing persistent hoarseness. Laryngoscope 1958;68(2):142–158.
  61. Bouchayer M, Cornut G, Loire R, et al. Epidermoid cysts, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases. Laryngoscope 1985;95(9 Pt 1):1087-1094.
  62. Sato K, Hirano M. Electron microscopic investigation of sulcus vocalis. Ann Otol Rhinol Laryngol 1998;107(1):56–60.
  63. Husain S, Sulica L. Familial sulcus vergeture: further evidence for congenital origin of type 2 sulcus. J Voice 2016;30(6):761.e19–761.e21.
  64. Giovanni A, Chanteret C, Lagier A. Sulcus vocalis: a review. Eur Arch Oto-Rhino-Laryngology 2007;264(4):337–344.
  65. Van CD. The etiology of the vocal cord furrow (in French). Ann Mal Oreille Larynx Nez Pharynx 1928;43:121–130.
  66. J P. The evolution of an epidermoid cyst during vocal mutation (in Portuguese). Behlau M, ed O Melhor Que Vi e Ouvi Atualiza.oem Laringol e Voz Revinter 1998;114–120.
  67. Hirano M, Yoshida T, Tanaka S, et al. Sulcus vocalis: functional aspects. Ann Otol Rhinol Laryngol 1990;99(9 Pt 1):679–683.
  68. Nakayama M, Ford CN, Brandenburg JH, et al. Sulcus vocalis in laryngeal cancer: a histopathologic study. Laryngoscope 1994;104 (1 Pt 1):16–24.
  69. Lee A, Sulica L, Aylward A, et al. Sulcus vocalis: a new clinical paradigm based on a re-evaluation of histology. Laryngoscope 2016;126(6):1397–1403.
  70. Ford CN, Inagi K, Khidr A, et al. Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol 1996;105(3):189–200.
  71. Pontes P, Behlau M, Gon A. Minor structural alterations of the larynx: basic aspects (in Portuguese). Acta AWHO 1994;2:175–185.
  72. Nerurkar NK, Nagree Z, Agrawal D. Proposal of a classification for sulcus following microlaryngoscopy with a retrospective study of the results of a laser-assisted sulcus release surgery. Int J Phonosurgery Laryngol. 2020;10(1):3–8.
  73. Dailey SH, Spanou K, Zeitels SM. The evaluation of benign glottic lesions: rigid telescopic stroboscopy versus suspension microlaryngoscopy. J Voice 2007;21(1):112–118.
  74. Lindestad PA, Hertegård S. Spindle-shaped glottal insufficiency with and without sulcus vocalis: a retrospective study. Ann Otol Rhinol Laryngol 1994;103(7):547–553.
  75. Nerurkar NK, Gupta HK, Shedge AE. Diagnostic challenge of sulcus vocalis made easier. Int J Phonosurgery Laryngol 2015;5(2):39–41.
  76. Rajasudhakar R. Effect of voice therapy in sulcus vocalis: A single case study. S Afr J Commun Disord 2016;63(1):e1–5.
  77. Miaśkiewicz B, Szkiełkowska A, Gos E, et al. Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients. Eur Arch Otorhinolaryngol 2018;275(11):2763–2771.
  78. Hirano M. Phonosurgery: basic clinical investigations. Otol 1975;21(Suppl. 1):239–442.
  79. Saito S. Phonosurgery: basics on the mechanism of phonation and endolaryngeal microsurgery. Otol 1977;23(Suppl. 1):171–386.
  80. Roch JB, Bouchayer M, Cornut G. Le sulcus glottidis [Sulcus glottides]. Rev Laryngol Otol Rhinol (Bord) 102(7–8):333–346.
  81. Pontes P, Behlau M. Treatment of sulcus vocalis: auditory perceptual and acoustical analysis of the slicing mucosa surgical technique. J Voice 1993;7(4):365–376.
  82. Shapshay SM, Beamis JF Jr, Hybels RL, et al. Endoscopic treatment of subglottic and tracheal stenosis by radial laser incision and dilation. Ann Otol Rhinol Laryngol 1987;96(6):661–664.
  83. Netterville JL, Stone RE, Luken ES, et al. Silastic medialization and arytenoid adduction: The Vanderbilt experience. Ann Otol Rhinol Laryngol 1993;102(6):413–424.
  84. Hsiung M-W, Lin Y-S, Su W-F, et al. Autogenous fat injection for vocal fold atrophy. Eur Arch Oto-Rhino-Laryngology 2003;260(9):469–474.
  85. Sataloff RT, Spiegel JR, Hawkshaw MJ. Vocal fold scar. Ear, Nose Throat J 1997;76(11):776
  86. Tsunoda K, Baer T, Niimi S. Autologous transplantation of fascia into the vocal fold: long-term results of a new phonosurgical technique for glottal incompetence. Laryngoscope 2001;111(3):453–457.
  87. Tsunoda K, Niimi S. Autologous Transplantation of Fascia Into the Vocal Fold. Laryngoscope 2000;110(4):680–682.
  88. Tsunoda K, Takanosawa M, Niimi S. Autologous transplantation of fascia into the vocal fold: a new phonosurgical technique for glottal incompetence. Laryngoscope 1999;109(3):504–508.
  89. Welham N V, Rousseau B, Charles NF, et al. Perceptual, instrumental, and psychosocial outcomes after phonosurgery for sulcus vocalis. Otolaryngol Neck Surg 2004;131(2):p257
  90. Ford CN, Bless DM, Campbell D. Studies of injectable soluble collagen for vocal fold augmentation. Rev Laryngol Otol Rhinol (Bord) 1987;108(1):33–36.
  91. Chang Z, Kishimoto Y, Hasan A, et al. TGF-β3 modulates the inflammatory environment and reduces scar formation following vocal fold mucosal injury in rats. Dis Model Mech 2014;7(1):83–91.
  92. Pitman MJ, Cabin JA, Iacob CE. Small intestinal submucosa implantation for the possible treatment of vocal fold scar, sulcus, and superficial lamina propria atrophy. Ann Otol Rhinol Laryngol 2016;125(2):137–144.
  93. Hirano S, Kawamoto A, Tateya I, et al. A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus. J Tissue Eng Regen Med 2018;12(4):1031–1038.
  94. Martins RHG, Tavares ELM, Fabro AT, et al. Mucosal bridge of the vocal fold: difficulties in the diagnosis and treatment. J Voice 2012;26(1):127–131.
  95. Nerurkar NK, Sapre A, Gosavi R. Mucosal bridges (MB): a 9-year retrospective study of their incidence with a third variant proposed. Eur Arch Otorhinolaryngol 2019;276(1):159–165.
  96. Pontes P, Behlau M, Gonc, et al. Minimal structural alterations (MSA) of the larynx: basic considerations Acta AWHO. 1994;13:2–6.
  97. Kocak I, Aslan G, Dogan M, et al. Vocal fold bridge: a complication of a sulcus cyst surgery. J Voice 2010;24(2):240–241.
  98. Schweinfurth J, Ossoff RH (2018)http://emedicine.medscape.com/article/86609 4-overview#a8. Accessed 31 Mar 2018.
  99. Bolzoni Villaret A, Piazza C, Rossini M, et al. Triple mucosal bridge of the glottis. Otolaryngol Head Neck Surg 2007;137(4):678–679.
  100. Sataloff RT, Rosen C, Hawkshaw M. Occult mucosal bridge of the vocal fold Ear Nose Throat J. 1997;76(12):850.
  101. Tanaka S, Hirano M, Umeno H, et al. [Mucosal bridge of the vocal fold]. Nihon Jibiinkoka Gakkai Kaiho 1991;94(12):1853–1856.
  102. Sataloff RT, Chowdhury F, Joglekar S, et al. Atlas of endoscopic laryngeal surgery. First. Jaypee Brothers Medical Publishers Ltd 2011. p 130–132.
  103. Tan M, Pitman MJ. A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp. J Voice 2011;25(4):484–486.
  104. Kim H. New surgical technique for mucosal bridge of vocal fold: sandwich mucosal flap surgery (Yeson Voice Center Website). 2008.
  105. Chang JW, Park AY, Byeon HK, et al. Use of pulsed dye laser treatments in patients with vocal fold mucosal bridges with sulcus vocalis - our experience of five cases. Clin Otolaryngol 2017;42(3):715–719.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.