OVERVIEW

What is the function of the vocal cords?

The vocal cords are the sound-producing organs in the human body, responsible for speech, singing, and vocalization. There are two vocal cords, resembling white bands with smooth edges. They are connected at the front and can open and close at the back.

In adult males, the average length of the vocal cords is about 21 mm, while in adult females, it is approximately 17 mm. Located in the neck at the level of the Adam's apple, the vocal cords are the true gateway of the throat. Above them lies the pharynx, and below them connects to the airway. Figuratively speaking, the vocal cords act like two doors at the entrance of the airway that can open and close. The space between the two vocal cords is called the glottis, through which air passes in and out of the airway.

In terms of size, the vocal cords are very small compared to the entire human body, but their function is one of the most vital for human survival.

The two primary functions of the vocal cords are sound production and respiration, achieved through vertical vibrations and horizontal opening and closing movements.

• During sound production, the two vocal cords close and vibrate to produce sound.

• The movement of the vocal cords is closely related to breathing. Normally, when we breathe, the vocal cords fully open to allow sufficient air to pass through the glottis into the airway below.

What are vocal cord polyps?

Vocal cord polyps, as the name suggests, are polyps that grow on the vocal cords and are one of the most common benign lesions of the vocal cords.

Visually, vocal cord polyps appear pale, transparent, swollen, or gel-like, somewhat resembling lychee flesh. If accompanied by bleeding or congestion, the polyps may appear red, dark red, or purple, with a smooth surface.

The size of vocal cord polyps varies greatly among patients, ranging from less than 1 mm to several centimeters in diameter. Additionally, based on their attachment to the vocal cords, polyps can be pedunculated (like a watermelon with a stem) or sessile (with a broad base).

Most patients have polyps on one vocal cord, but many also have polyps on both vocal cords simultaneously.

SYMPTOMS

What are the symptoms of vocal cord polyps?

The main symptoms of vocal cord polyps include hoarseness, changes in pitch, breathy speech, vocal effort, and easy fatigue.

The presence and severity of these symptoms are related to factors such as the location of the polyp (on the edge or upper surface, front, middle, or back portion, one or both sides), size, base width (pedunculated or broad-based), and its impact on vocal cord vibration and glottal closure.

Can vocal cord polyps turn cancerous?

Vocal cord polyps are benign lesions and do not develop into cancer.

What consequences can vocal cord polyps cause?

Problems with the vocal cords primarily affect voice production and breathing.

• The impact on voice production mainly depends on vocal cord vibration and closure.
• If vocal cord vibration is affected—such as weakened, absent, or asynchronous vibration (one side vibrating faster than the other)—symptoms like hoarseness, roughness, pitch changes, weak voice, vocal effort, and fatigue may occur. Almost all vocal cord conditions affect vibration to some degree.
• Issues with vocal cord closure include incomplete or excessive closure. If the vocal cords do not close tightly, air leakage during speech can cause hoarseness, breathiness, and vocal strain. If the cords close too tightly, excessive squeezing may lead to shaky, strained, or interrupted speech, along with vocal fatigue.
• The impact on breathing depends on the degree of glottal narrowing. If the glottis becomes too small, insufficient air enters the airway, leading to breathlessness, choking sensations, or even suffocation in severe cases. Conditions like vocal cord paralysis are common causes. With unilateral paralysis, breathing difficulties (e.g., during exercise like climbing stairs or running) may occur, while daily activities remain unaffected. Bilateral paralysis significantly narrows the glottis, severely impairing breathing and potentially requiring a tracheostomy.

CAUSES

What are the causes of vocal cord polyps? Why do vocal cord polyps form?

Vocal cord polyps are often associated with excessive talking, loud speech, incorrect speaking techniques, smoking, and long-term chronic inflammation.

Therefore, occupations that heavily rely on voice use—such as teachers, salespeople, singers, hosts, restaurant servers—as well as heavy smokers are high-risk groups for vocal cord polyps. It is also common for patients to experience prolonged hoarseness after a cold, leading to the discovery of vocal cord polyps upon examination.

Is there a connection between vocal cord polyps and colds?

A simple cold does not directly cause vocal cord polyps.

During a cold, symptoms like hoarseness and sore throat often occur, and the vocal cords may become congested and swollen. If one continues to strain their voice excessively during this time, it may lead to the development of vocal cord polyps.

DIAGNOSIS

How is vocal cord polyp diagnosed?

When vocal cord polyps are suspected, doctors can usually diagnose them through laryngoscopy. Laryngoscopy is an examination method that allows direct observation of the throat condition, enabling visualization of any other lesions in the throat area, as well as the location, size, and number of vocal cord polyps.

TREATMENT

What should be noted after the onset of vocal cord polyps? How should vocal cord polyps be treated?

• The most important thing after discovering vocal cord polyps is to speak less (avoid speaking whenever possible).
• For very small polyps, cases with mild hoarseness, or patients unwilling to undergo surgery, observation for 1–3 months through voice rest or speech therapy may be considered.
• For larger polyps or cases affecting breathing, surgical removal may be considered.
• Additionally, patients can undergo speech therapy.
• If the patient smokes, quitting smoking is essential to avoid further irritation to the vocal cords.

What medications are used to treat vocal cord polyps? Can medication shrink polyps?

So far, no specific medication has been proven to effectively treat vocal cord polyps.

For very small polyps, voice rest or speech therapy may sometimes reduce their size. However, relying solely on medication is unlikely to shrink or eliminate polyps. Drug treatment is usually only used to reduce inflammation as an adjunct to surgical removal or speech therapy.

How is vocal cord polyp surgery performed?

Vocal cord polyp surgery may sound simple—just removing the excess polyp—but in reality, because the vocal cords are a small yet highly delicate organ, the procedure is a technically demanding microsurgery.

The surgery is typically performed under general anesthesia. A laryngoscope is used to fully expose the vocal cords, and the polyp is completely removed under a microscope. There are no external wounds after the surgery.

What are the risks and complications of vocal cord polyp surgery?

Common surgical risks and complications include:

• Bleeding: The amount of bleeding during vocal cord polyp surgery is usually minimal and can be thoroughly controlled. Surgeons typically observe for a period after stopping the bleeding to ensure no further bleeding occurs. The highest risk of bleeding is within 24 hours post-surgery. If the patient only has slight blood-streaked phlegm, monitoring is sufficient. However, coughing up large amounts of fresh blood requires immediate medical attention.

• Sore throat: The laryngoscope used in surgery includes a thick metal hollow tube inserted through the mouth to expose the vocal cords, which may irritate the oral or throat mucosa. Some patients experience throat pain post-surgery, but this usually resolves within 3–5 days.

• No significant improvement in voice quality after surgery.

• Other risks include tooth loss, vocal cord adhesions, and general anesthesia complications.

Why might a front tooth fall out after vocal cord polyp surgery?

As mentioned earlier, the laryngoscope includes a thick metal tube inserted through the front of the mouth, near the front teeth. Some force is applied to the teeth, though not excessively. However, if a patient’s front teeth are already loose, they may be dislodged.

Surgeons take extra care to protect the front teeth, such as placing gauze or protective covers between the metal tube and teeth and minimizing pressure on the teeth.

Why is there no improvement or even worsening of the voice the day after vocal cord polyp surgery?

Due to surgical trauma (from scissors, forceps, scalpels, etc.), the vocal cords experience temporary swelling and inflammation post-surgery (for about 1–10 days). During this period, voice quality may be worse, and hoarseness may even be more severe than before surgery.

However, once the swelling and inflammation subside and the surgical wound heals, voice quality gradually improves.

Why doesn’t the voice return to normal after vocal cord polyp surgery?

The vocal cords are highly delicate organs, and even minor changes (such as dilated blood vessels) can affect voice production.

Regardless of the surgeon’s skill, the use of surgical instruments inevitably impacts vocal function to some degree. The extent of this impact depends on factors like the polyp’s size, location, base (broad-based or pedunculated), and the vocal cords’ pre-surgery condition (e.g., congestion, thickening).

In other words, while surgery removes the polyp affecting voice production, the procedure itself causes some vocal cord damage. Post-surgery voice quality depends on the balance between these two factors.

Specifically, if the polyp had minimal impact on the voice pre-surgery, post-surgery improvement may be less noticeable. Conversely, severe pre-surgery hoarseness often shows more significant improvement after surgery.

Why do dry throat, foreign body sensation, or obstruction persist after vocal cord polyp surgery?

Many patients experience dry throat, a sensation of obstruction, or a foreign body feeling in addition to hoarseness before surgery. These symptoms are often due to chronic pharyngitis.

Since vocal cord polyp surgery only removes the polyp, it does not address these chronic pharyngitis-related discomforts. They require additional treatment, such as medication or lifestyle adjustments (e.g., quitting smoking, speaking less, wearing masks in polluted environments).

Does vocal cord polyp surgery affect eating or drinking?

The surgery only involves the vocal cords, so it does not affect eating or drinking post-operation.

Is it possible to avoid surgery for vocal cord polyps?

Vocal cord polyps mainly affect voice production and quality. Unless a very large polyp obstructs the airway and causes suffocation, they are not life-threatening. Patients who prefer not to undergo surgery or wish to delay it can do so, though they may continue to experience hoarseness and difficulty speaking.

Are there non-surgical methods to shrink vocal cord polyps?

Besides surgical removal, speech therapy may help shrink polyps in select cases—such as small polyps in patients who can comply with training and follow medical advice.

What is post-surgery speech therapy for vocal cord polyps?

In simple terms, it involves systematic voice training under professional guidance to correct improper vocal habits and establish healthy speaking techniques.

What are the benefits of speech therapy for vocal cord polyps?

Speech therapy is beneficial both before and after surgery. Pre-surgery, it can minimize voice impairment, sometimes even avoiding surgery, while helping patients learn proper vocal techniques in preparation for recovery. Post-surgery, it reduces recurrence risk and enhances voice quality.

Can vocal cord polyps recur?

Since vocal cord polyps are closely linked to speaking habits and lifestyle, recurrence is likely if these underlying causes are not addressed.

DIET & LIFESTYLE

What aspects should be paid attention to after vocal cord polyp surgery?

Patients must maintain absolute voice rest for 2–3 days after surgery, as postoperative vocal cord swelling and redness require time to subside and heal. Gradually increase speaking volume after 2–3 days, but avoid excessive talking and practice deep breathing exercises whenever possible.

Consume soft foods (porridge, noodles, etc.) for the first three days after surgery, while quitting smoking and avoiding spicy or irritating foods. Nebulized throat therapy is recommended if available. Regular follow-ups should also be scheduled post-surgery.

Is speaking absolutely prohibited after vocal cord polyp surgery?

Many patients mistakenly believe they must refrain from speaking for an extended period (weeks or even months) after vocal cord surgery. This is incorrect. Particularly for patients who undergo bilateral vocal cord surgery, prolonged silence may lead to vocal cord adhesion, severely affecting voice recovery and potentially requiring additional surgery to remove adhesions. Therefore, patients should begin speaking gradually after 2–3 days of absolute voice rest.

PREVENTION

How to Prevent Vocal Cord Polyps?

Preventing vocal cord polyps primarily involves avoiding vocal misuse or overuse, such as speaking loudly, shouting, excessive talking, prolonged speech, frequent coughing or throat clearing, and speaking in excessively high or low pitches.