This condition is caused by accumulation of fluid in the loose space between the cover of the vocal cord and the underlying muscle (Reinke’s Space). This makes the vocal cord heavy and so it vibrates more slowly, this leads to a deeper pitch of the voice. The condition commonly affects women and often the patient will have had symptoms for many years but decide to visit the clinic when they are mistaken for a man when answering the phone. It is usually caused by irritation of the vocal cords by cigarette smoke or acid reflux and sometimes by a combination of the two.
The main way to treat it is to remove the irritant factors which should allow the swelling to settle. If the vocal cords become too heavy and swollen then polyps will result and usually this can only be treated with surgery.
Vocal cord Papillomas
This is an irregular growth on the vocal cords caused by infection with the human papilloma virus. It is more common in men and can occur in childhood or later in life. When the condition occurs later it may be due to a new infection or a re-activation of the virus that is already in the body. With the onset of vaccination programmes against the virus it is hoped that the condition will become less common, however as boys are not routinely immunized this may not be effective. Very occasionally the type of virus causes changes in the cells and may be associated with cancer but most of these papillomas are benign. The growths affect the ability of the vocal cords to close and if they get very big they can cause breathing difficulties although this is rare in adults.
The treatment is to remove the growths, there are a number of different methods to do this some using laser others with a surgical shaver or a coblation wand. The method of removal is usually a personal preference of the surgeon as there is no current evidence to suggest that one technique is better than another. As there is a tendency for the growths to recur the patients usually have to remain under follow up until there is no further recurrence.
Vocal Cord Palsy
The vocal cords move outwards when you want to breathe in and come together when you want to speak, cough swallow and also to conserve air when exercising. The muscles are controlled by a long nerve which comes out of the brain down through the neck and back up into the voice box this is called the recurrent laryngeal nerve. Due to the fact that the nerve is so long there are many places where it can be damaged so the whole length of the nerve needs to be looked at with scans if a vocal cord palsy is diagnosed. Patients with a vocal cord palsy will often have a weak voice with a breathy whispery tone. They may have difficulty swallowing liquids and find exertion makes them more out of breath.
After finding a cause for the vocal cord not moving the next thing is to try and get the voice better. This may happen spontaneously or may require help from Speech therapy or surgery. The surgery may be a simple injection or a more complicated operation called a thryoplasty.