ENT: Vocal Cord Polyps
High-Yield Revision Notes for Board Review & PG Entrance Examinations
A vocal cord polyp is a benign, often unilateral, fluid-filled lesion that develops in the superficial lamina propria (Reinke’s space) of the vocal cord. It is typically associated with vocal abuse or trauma.
1. Clinical Presentation
- Hoarseness: The most common presenting symptom, usually progressive.
- Diplophonia: A characteristic “double voice” may occur if the polyp is large enough to interfere with the vibration of the opposite cord.
- Location: Typically found at the junction of the anterior and middle thirds of the vocal cord (the point of maximum impact).
2. Polyp vs. Nodule (The “Board” Comparison)
| Feature | Vocal Polyp | Vocal Nodule (Singer’s Nodule) |
|---|---|---|
| Laterality | Unilateral | Bilateral (Symmetric) |
| Demographics | Adults (often smokers) | Children (boys) / Adult females |
| Mechanism | Acute vocal trauma/hemorrhage | Chronic vocal abuse |
| Treatment | Surgical excision | Voice therapy (conservative) |
3. High-Yield Clinical Facts
- Pathology: Often categorized as hemorrhagic (reddish) or hyaline/fibrotic (pale).
- Management: Unlike nodules, polyps rarely respond to voice therapy alone and usually require microlaryngoscopic excision.
- Diagnostic Pearl: Always perform laryngostroboscopy to distinguish a polyp from other lesions like cysts or early carcinoma (which can mimic a polyp).