Vocal cord polyps (referred to as “vocal fold” polyps by physicians) are unusual in children and adolescents. They are benign (noncancerous) lesions or growths that are located on the surface of the vocal cords.
Vocal cord polyps are often confused with vocal cord nodules, as both often occur after chronic abuse of the voice box. Polyps, however, are usually larger than nodules and are more blister-like and swollen (while nodules are more like callouses).
The signs and symptoms of vocal cord polyps or throat polyps include a strained or breathy voice. Polyps should be considered in a person who was diagnosed with vocal cord nodules that did not respond to voice therapy.
Vocal cord polyps are thought to be the result of chronic abuse of the voice. People who were diagnosed with vocal cord nodules that did not respond to voice therapy may actually have polyps.
Gastroesophageal reflux disease (GERD) can also worsen symptoms from vocal cord polyps.
The diagnosis of vocal cord polyps is most often made by laryngoscopy or stroboscopy, tests that examine the voice box while your child is awake. Rarely, microlaryngoscopy is used.
- Laryngoscopy: A doctor will place a spaghetti-like camera in your child’s nose and down the throat. This allows our team to look at your child’s voice box, or larynx.
- Stroboscopy: A small, thin, flexible endoscope with a camera is gently inserted through the nose to the area in the back of the throat above the vocal cords. The study evaluates the motion of your child’s vocal cords when there are concerns regarding the strength, pitch and quality of his voice.
- Microlaryngoscopy (under anesthesia): This form of evaluation is rarely needed. It is a procedure under anesthesia that is used for taking an even closer look at the vocal cords, and is reserved for more confusing or difficult to treat cases.
Since polyps are likely the result of chronic voice abuse and misuse, we recommend a course of voice therapy to help reduce straining.
If there is no response to therapy, and if the voice problem is significant, then surgical removal of the polyps may be recommended.
The outlook for patients with vocal cord polyps is good when voice habits can be improved with therapy. When surgery is needed, it is important to follow the recommendations of the voice specialists after surgery to avoid voice abuse and straining and ensure the best surgical outcome possible.
Management of possible allergies and reflux can also help reduce inflammation before and after therapy or surgery.
If voice therapy is recommended, the initial follow-up will be about three months after beginning therapy in order to assess progress and response.
If reflux management is recommended, a three-month follow-up in clinic may be recommended as well.
If there is no response to voice therapy and/or medical therapy, a surgical intervention may be recommended. The follow-up after surgery will include voice therapy with your child’s speech pathologist, and return visits to the clinic at about one, three, six and 12 months post-surgery.
Our voice team at The Children’s Hospital of Philadelphia’s Voice Program is a dynamic multidisciplinary group of professionals with years of experience managing pediatric voice problems.