What happens to the link?
When speaking, the vocal folds close and vibrate hundreds of times per second. With a sharp cry or prolonged loud speech, small vessels in the mucous membrane are damaged, swelling and hemorrhage occur, and in this place a protruding formation gradually forms on a broad base or on a pedicle. The polyp prevents the folds from closing tightly, some of the air passes through empty, and the voice sounds hoarse and aspirated. A polyp differs from nodules in that it is usually single, larger, and more often associated with a single episode of overload.
- Damage to mucosal vessels due to overload
- Swelling and tissue proliferation
- Broad-based or pedunculated polyp
- Most often unilateral formation
- Incomplete closure of vocal folds
- Difference from nodules: singleness and size
Causes and risk factors
The main reason is excessive and incorrect vocal load: shouting, prolonged conversations in a raised voice, singing without equipment, working in a noisy room. Smoking, which maintains chronic inflammation of the laryngeal mucosa, significantly increases the risk. The reflux of acidic stomach contents into the pharynx, allergic and chronic laryngitis, dry and dusty air, and the use of certain medications that affect the mucous membrane all contribute. For people in vocal professions, the combination of stress and irritating factors is especially common.
- Screaming and prolonged loud speech
- Singing without voice
- Smoking
- Gastroesophageal reflux
- Chronic and allergic laryngitis
- Dry, dusty or smoky air
- Voice professions: teachers, salespeople, singers
Symptoms
The main complaint is hoarseness, which does not go away and is not related to a cold. The voice loses its ringing, sounds rough, breathy, gets tired quickly, and gets worse in the evening. A person has to strain to speak loudly, his range decreases, and singers are unable to reach the top notes. There may be a sensation of a lump or foreign body in the throat, and a desire to cough. Large polyps sometimes cause a feeling of shortness of breath when speaking. Pain is not typical, and its occurrence requires special attention from a doctor.
- Persistent hoarseness and hoarseness
- Breathy voice, loss of sonority
- Rapid voice fatigue
- Narrowing of range, difficulty singing
- Feeling of a lump in the throat and coughing
- Symptoms worsen in the evening
- Difficulty breathing with a large polyp
Diagnostics
The diagnosis is made by examining the larynx. Indirect laryngoscopy with a mirror gives a general idea, but more precisely, endoscopic examination with a flexible or rigid endoscope: it allows you to examine the size, shape and location of the formation, assess the closure of the folds and the mobility of the larynx. Videostroboscopy shows the nature of mucosal vibrations, which is important for phoniatric assessment. If the formation looks atypical or there are alarming signs, a biopsy with histological examination is performed to exclude a malignant process.
- Examination by an ENT doctor and indirect laryngoscopy
- Endoscopic examination of the larynx
- Video stroboscopy of vocal folds
- Voice Function Assessment
- Biopsy for an atypical picture
- Testing for reflux if suspected
- Examination of the neck and lymph nodes
Treatment and prevention
They start by eliminating the causes: voice rest, smoking cessation, treatment of reflux and chronic laryngitis, air humidification and sufficient drinking. A small fresh polyp may shrink due to such measures. If the formation has formed and hoarseness persists, it is removed - usually endoscopically, under general anesthesia, with careful attention to the mucous membrane. After the operation, strict vocal rest is required for several days, and then a gradual return to exercise, preferably under the guidance of a phonopedist. Without changing habits, polyps may reappear.
- Voice rest and load dosing
- Quitting smoking
- Treatment of gastroesophageal reflux
- Humidify the air and drink enough fluids
- Endoscopic polyp removal
- Voice rest after surgery
- Lessons with a phonopedist and voice training
