What are vocal fold granulomas?
A granuloma is a benign large growth that typically occurs at the posterior (back) third part of vocal fold, located in the larynx (voice box). Contact granulomas may occur on one or both of the vocal folds. Granulomas may occur directly on the vocal fold or on one of the mucosal surfaces located on the vocal process. The growth may prevent and inhibit adequate glottic closure as the vocal folds are not able to adduct to midline. This impacts voice directly, as the vocal folds must come together (adduct) in unison in order to produce voice. A granuloma that is not located on the vocal fold may not interfere with vocal quality directly, but may instead obstruct the airway, causing irritation and discomfort.
The most common cause of vocal fold granulomas are due to complications associated with intubation and/or extubation following insertion of an endotracheal tube. Vocal fold granulomas may also be caused by phonotraumatic behaviours, that is, behaviours that cause trauma to laryngeal health. These may include irritation to the vocal folds from excessive or improper use of voice. Another common cause of vocal fold granulomas is backflow of stomach acids occurring at the level of the vocal folds (i.e., laryngopharyngeal reflux).
Symptoms and common complaints
Dysphonia is a term given to disorders of the voice. Essentially, the term dysphonia refers to the inability to produce sounds using the vocal organs. The most typical symptoms/complaints associated with vocal fold granulomas may include:
- Abnormal vocal quality
- Inadequate resonance
- Vocal fatigue
- Difficulty with breathing
- Irritation in the throat
Treatment for vocal fold granulomas
An Ear Nose and Throat specialist will diagnose the presence of vocal fold granulomas. Voice therapy and improved vocal hygiene is the preferred management option for the treatment of vocal fold granulomas. A speech language pathologist is able to advise an appropriate management plan. This may include reduction of vocal irritants, adjustments to vocal behaviours and regular voice therapy. In some cases, surgical intervention may be required to improve voice quality.
If you have questions or concerns about your voice contact your local doctor, who will arrange for you to see a speech pathologist. We‘ll provide you with a straightforward, efficient and very effective treatment plan targeted to your concerns.
Colton, R.H., & Casper, J.K. (1996). Understanding voice problems: A physiological perspective for diagnosis and treatment (2nd ed.). USA: Lippincott Williams & Wilkins.