Don't Ignore a Persistent Change in Voice...
July 1, 2019
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It can be your first sign of a vocal injury, especially one that may look like this! If you experience a sudden change in voice or a persistent “hoarseness” for two weeks or longer, seek out a medical professional who specializes in voice (STAT!). This picture depicts a right hemorrhagic vocal fold polyp (left side of the screen is actually the right vocal fold). Polyps are benign (non-cancerous) growths on either one or both vocal folds (although they are usually unilateral) and tend to be more vascularized than vocal fold nodules (which means they have more blood vessels). Polyps can vary in size and shape, but are usually larger than nodules and resemble “blisters”. Years ago I remember being told that polyps are “fluid-filled sacs”, and they can either be sessile (broad-based) or pedunculated (growing from/off of a small stalk). As you can see, this polyp is filled with blood (hemorrhagic) and was developed as a result of this patient’s significant coughing while she had an upper respiratory infection a few months back.
Acute trauma (ex: one loud cough or yell) or chronic irritation (ex: extensive coughing or continued inefficient voice use) can cause changes in the vocal folds that can lead to vocal fold polyps. People who use their voices for a living or those who shout/speak loudly are at high risk.
Symptoms of a vocal fold polyp may include general hoarseness, a decrease in habitual/normal pitch, breathiness, loss of vocal range, vocal fatigue, raspiness, &/or the presence of voice breaks. Pain in the throat or neck, a feeling of a lump in the throat, and frequent coughing/throat clearing are also common symptoms.
Polyps will need to be removed via surgery the majority of the time, but occasionally (if small in size and soft/new), polyps may resolve with voice therapy. Initial (pre-surgery) voice therapy is recommended to decrease inflammation surrounding the polyp and improve negative voice habits that may have caused it in the first place as well as teach what to expect in surgery and how to promote the best healing of the vocal fold(s). Voice therapy is also recommended after surgery to limit the chances of recurrence and also aid in transformation/reformation of vocal health and use habits.
To prevent vocal pathologies caused by inefficient voice use such as overuse and/or phonotrauma, you should learn how to take the most optimal care of your vocal mechanism (your “instrument”) and use it in the most efficient and effective ways possible. Find a licensed and certified speech pathologist who specializes in voice and prioritize your vocal health!
