What surgical procedure is performed on the vocal cords after vocal strain from singing?

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Last updated: May 11, 2025 • View editorial policy

From the Guidelines

Surgery for vocal cord strain from singing is typically considered only after conservative treatments, including voice rest and speech therapy, have failed, and a thorough evaluation, such as laryngoscopy, has been performed to assess the extent of the damage 1. When considering surgery, procedures like vocal cord microsurgery or phonosurgery may be recommended to repair damage such as nodules, polyps, or cysts.

  • The most common procedure is phonomicrosurgery, where a surgeon uses specialized instruments to precisely remove lesions while preserving healthy vocal cord tissue.
  • Before surgery, patients undergo a thorough evaluation including videostroboscopy to visualize the vocal cords.
  • Recovery typically requires complete voice rest for 1-2 weeks followed by gradual voice rehabilitation with a speech therapist.
  • Voice therapy has been demonstrated to be effective for dysphonia and is often used as a first-line treatment for vocal fold lesions, such as vocal nodules, polyps, or cysts 2. The decision for surgery should be made in consultation with an otolaryngologist (ENT) who specializes in voice disorders, as not all vocal strain requires surgical intervention, and proper rehabilitation is essential to prevent recurrence of vocal problems.
  • Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected 1.

From the Research

Vocal Cord Surgery

The type of surgery for vocal cords after restraining from singing depends on the underlying condition.

  • For persistent symptomatic nodules, surgery is reserved as a treatment option 3.
  • For cancerous lesions, surgery is also a treatment option 3.
  • However, for benign inflammatory lesions such as vocal cord granulomas, surgical excision is not helpful as they tend to recur 4.
  • For other benign laryngeal lesions, treatment options include voice therapy, phonomicrosurgical techniques, and the use of the pKTP laser as well as intralesional injections 5.

Diagnostic Procedures

Before undergoing surgery, diagnostic procedures such as laryngoscopy are necessary to evaluate the vocal folds 3, 6.

  • Laryngoscopy can help identify the underlying condition and determine the best course of treatment.
  • In some cases, a computer-aided diagnosis system based on deep convolutional neural network and transfer learning can be used to classify vocal cord lesions 7.

Treatment Options

Treatment options for vocal cord lesions include:

  • Voice therapy and speech therapy 3, 4, 6
  • Vocal hygiene and voice counselling 4, 6
  • Antacids for gastro-oesophageal reflux 4
  • Surgery for persistent symptomatic nodules and cancerous lesions 3
  • Phonomicrosurgical techniques and the use of the pKTP laser as well as intralesional injections for benign laryngeal lesions 5

References

Guideline

clinical practice guideline: hoarseness (dysphonia) (update).

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018

Guideline

clinical practice guideline: hoarseness (dysphonia) (update).

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018

Research

Vocal Cord Disorders.

Primary care, 2025

Research

Updated Medical and Surgical Treatment for Common Benign Laryngeal Lesions.

Otolaryngologic clinics of North America, 2019

Research

Hoarseness in adults.

American family physician, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.