Phonotraumatic Lesions: Vocal Nodules, Polyps, And Others
Article Sections
Introduction
Phonotraumatic lesions of the vocal cords include vocal nodules, polyps, fibrous masses, and intracordal cysts and are a common cause of hoarseness. They arise in the "striking zone" of the vocal cords and are caused by local trauma due to vocal overuse or abuse.
Pathogenesis and pathology
The vocal cords (folds) are made of 3 layers of tissue:
- Epithelium (mucosa)
- Lamina propria (gelatinous; composed of a superficial [Reinke], intermediate, and deep layer)
- Underlying muscle (thyroarytenoid or vocalis)
The differences in the density of these layers allow for the specialized vibration that produces sound.
Repetitive mechanical trauma to the vocal cords, which is most pronounced at the "striking zone" (the point of maximum vibration at the junction of the anterior and middle thirds of the vocal cords), leads to changes primarily in the gelatinous lamina propria layer, which then impairs vibration, causing hoarseness.
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