LARYNX POLYPS & NODULES
Among the most frequent causes for hoarseness, fatigue, voice interruption are larynx polyps and nodules.
They are observed both in adults and in children and are benign.
Α) Conservative treatment
The conservative treatment is related to the causal factors, as both nodules (calluses) and vocal chord polyps affect the use of the voice and technique.
Persons talking much, loudly, singing without technique, may cause fatigue and injury to the vocal chords. When these injuries are repeated, protrusions are formed in the vocal chord mucous which end in nodules or polyps.
Smoking also causes vocal chord edema and enlargement.
Therefore, when we correct the underlying causal factors, mainly via speech therapy and training in the use of the voice we will have led to healing, particularly when they are in the initial stages.
Good voice hygiene and hydration help a lot to make the nodules and polyps subside. This means giving up or at least reducing smoking, steam inhalation, drinking liquids.
However, when there are large polyps causing the patient serious functional problems, fatigue and breathing difficulty or suspicion of malignancy the indication for surgical operation is absolute.
Β) Surgical treatment
The most modern operation for the removal of vocal chord polyps is vocal chord surgery.
It concerns benign larynx diseases like the polyps and sizeable nodules. Delicate handling is required which is done with a high-resolution surgical microscope and extremely fine instruments. The use of a microflap from the vocal chord mucous is very effective, so there is no free traumatic surface, healing and therefore speech is facilitated.
The use of CO2 laser is also considered safe and effective.
The operation lasts for about ½ an hour and general anesthesia is required, but short hospitalization, which means that the patient leaves on the same day. The operation is totally painless.
It is recommended to stop talking after surgery, depending on the size and location of the damage, the operation which took place but also the condition of the patient. Usually 3 days’ aphonia is required and gradual return to normal speech within 10-15 days.
Free food intake.
Results and prognosis
Vocal chord polyp and nodule removal surgery is safe and effective and results in improved voice, aerodynamics (breathing in) and stroboscopic control.
The possibility for the polyps and nodules to reappear depends on bad use of the voice and hygiene rules which mainly are about smoking, alcohol and gastroesophageal reflux.
It is recommended to participate post-operatively in speech therapy sessions, give up smoking and protective therapy for GOR (against reflux).
Patients who cannot or will not follow instructions are bad candidates for vocal chord surgery.
Smoking is the most important factor in larynx cancer, increasing the risk by 20 times compared with non-smokers. Chronic alcohol consumption combined with smoking has synergistic action.
The diagnosis is done by larynx endoscopy and imaging like a throat and CT or MRI.
By suspicion for cancer an immediate biopsy under general anesthesia is carried out.
The treatment depends on the disease stage.
In early larynx cancers localized in specific areas surgical cleaning by laser is preferable.
Radiotherapy is also an effective treatment in early larynx cancer.
If treated immediately, the prognosis for larynx cancer is very good and survival rates high in all ages.