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