Ask a Doctor: Vocal Cord Granulomas

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

Today, we highlight a common issue among our voice patients: vocal cord granulomas.

Prepared by: Sean Walsh
Reviewed by: Dr. Sandra Stinnett

What are vocal cord granulomas?

Granulomas are small, typically noncancerous masses that are a result of inflammation or injury. They can be found anywhere in the body; however, the focus here will be on granulomas found on or around the vocal folds.

Vocal cord granulomas are more often localized on the posterior portion of the vocal cords.

What are its causes and symptoms?

Causes of vocal cord granulomas include:
-Irritation or injury to the vocal cords (most common)
-Irritation from placement of a breathing or feeding tube
-Excessive acid reflux that travels to the throat
-Excessive coughing

Some common symptoms include (but are not limited to):
-Pain while speaking, singing, or swallowing
-Perception of something stuck in the throat
-Hoarseness or breaks in the voice
-Ear pain on the side of the granuloma
-Dry cough

The symptoms arising from vocal cord granulomas can become cyclic. When a granuloma appears, the feeling of something lodged in the back of the throat will most likely elicit a dry cough. The excessive coughing will cause more irritation to the vocal folds and further granuloma formation.

Treatment options:

Treatments include:
-Anti-reflux medication
-Voice therapy
-Removal of breathing or feeding tube from throat
-Inhaled corticosteroids
-Surgery

Often, the irritation that causes the vocal cord granuloma comes from excessive reflux that travels to the throat, in the absence of heart burn. That is why it may be beneficial to take acid-reflux medication or inhaled medications. These medications can reduce the reflux and irritation and give the vocal cords time to heal.

If the irritation is from excessive use of the voice, voice therapy may be the best option for healing the vocal cord granuloma. Both of these options can be done at home and could help clear up the granulomas.

However, if these solutions do not work, then surgery may be the next best step in solving the issue.

When should I see a doctor?

If you experience any of the symptoms (throat pain, voice hoarseness, or dry cough) and have had recent exposure to the previous mentioned causes of vocal cord granulomas, then you should set up an appointment with your primary care doctor to get it checked out.

If the symptoms persist beyond 3-4 weeks, you should be seen by a specialist that can examine your larynx or voice box.

How will my doctor diagnose vocal cord granulomas?

After asking about your relevant symptoms and taking your medical history, your doctor will perform a physical exam to assess for any other associated issues.

Typically, they will refer you to an Otolaryngologist (ear, nose and throat specialist) who will further exam your vocal cords. The procedure to view your vocal cords is called a videostroboscopy: a small video camera is placed in the back of your throat to capture a clear picture of the vocal cords and voice box.

How can I prevent them?

The best way to prevent vocal cord granulomas is to avoid irritating the vocal folds, which can be challenging because we use our vocal cords all of the time. Following the behavioral changes listed in the treatment options can help reduce the recurrence of vocal cord granulomas.

How can our Dream Team help?

UTHSC ENT’s Dream Team provides world class treatment in your hometown. Our resident Voice Box Doctor, Sandra Stinnett M.D., is a renowned voice specialist and expert in treating vocal cord granulomas.

If you have a vocal cord issue, Dr. Stinnett should be your first call!