Vocal cord cyst: Causes, symptoms and treatment

Vocal cord cyst is a benign lesion but can also affect the voice. The essence of the vocal cord cyst is a fluid-filled sac secreted from the epithelium containing many small glands on the surface of the vocal cords. However, with early detection and proper intervention, patients can completely restore their voice.

The surface of the vocal cords is covered with mucous glandular epithelium and is arranged to form folds. It is these folds that make it easier for the vocal cords to vibrate and form the voice. The timbre of speech and singing varies from person to person depending on the variety of these structures. Because of the texture of folds, sometimes, one of the mucous-secreting glands in this epithelium will not be able to drain the secretions out. As a result, an accumulation of mucinous sheath forms a vocal cord cyst. In general, vocal cord cysts usually appear only in a certain fold, on the same side of the vocal cords, so it helps to distinguish them from other lesions here such as vocal cord polyps, vocal cord papillomas, .. In addition, vocal cord cysts rarely respond to voice therapy and therefore require radical surgery with microsurgical instruments. The goal of treatment is to preserve the normal structure and function of the vocal folds as much as possible. In particular, the thin coating of the vocal folds also needs to be protected and scarred as little as possible.

Vocal cord cysts may occur secondary to overuse of the voice or may be due to the epithelial layer being trapped in the folds. In addition, mucus-storing cysts may occur spontaneously or may be related to poor vocal hygiene. As the accumulation increases, the cysts increase in size, and they can begin to significantly affect the vibrating area of ​​the vocal cords and manifest in voice changes. In addition, some studies suggest that Streptococcus pseudopneumoniae and possibly Pseudomonas, play a role in the causes of vocal fold lesions of a benign nature, such as cysts and nodules. , polyps and edema. However, these strains of microorganisms are not easily detected through testing of saliva samples, throat swabs or common respiratory tract specimens.
At the same time, even minor trauma, repeated due to excessive talking or singing can also lead to the development of vocal cord cysts and polyps in situ.

The reason why the patient comes to the doctor is because of the persistent hoarseness, which can be simple or accompanied by symptoms of difficulty speaking, having to use a lot of force to pronounce, fatigue, pain when needing to use the voice. . Some patients who are singers will experience sudden loss of voice or difficulty in a certain pitch. Others may experience double voice, where two voices speak at two different pitches at the same time.
Furthermore, if the patient goes to the doctor because of a complete loss of voice or difficulty breathing or swallowing, the vocal cord cyst may have become heavy, large in size and cause compression.
On laryngoscopy, a vocal cord cyst may appear as fullness in the fold or simply as a light-colored border. A well-defined mass such as a tumor suggestive of a vocal cord cyst may be suspected only in patients presenting with hoarseness, difficulty speaking, or loss of voice.

Laryngoscopy is essential in diagnosing cysts. While indirect laryngoscopy images are often unclear and confusing, direct endoscopy helps doctors make more precise delineations.
Once the diagnosis is confirmed, medical treatment is still the first step in the intervention of vocal cord cysts. In particular, the goal of minimizing edema and swelling around inflammation plays the most important role. At the same time, limiting the use of voice, vocals, and good language hygiene also help vocal cord cysts to reduce inflammation and edema. In practice, patients are often advised to refrain from vocalization for a period of two weeks in addition to taking high-dose corticosteroids with anti-inflammatory analgesics. If steroid treatment reduces inflammation and improves symptoms while the local physical damage is not significantly changed, this is also a way to confirm the diagnosis of vocal cord cysts.
Besides, some other causes can also affect the voice and also need to be identified and evaluated such as reflux gastritis, allergic rhinitis. At this time, the intervention of these pathologies is the key that needs to be solved.
In the case of patients with complex dysfunctional vocal cysts, vocal cord surgery should be considered, especially when medical therapy alone is difficult to resolve. Although nodular lesions and vocal cord polyps may respond to medical therapy, vocal cord cysts usually cannot. Furthermore, for whatever reason causes a delay in surgical treatment and continued trauma, damage to the vocal cords has the potential to lead to progression, scarring, and permanent adhesions. far.
Therefore, surgical intervention should be set out and carried out as soon as possible as soon as the patient has the right indication. The goal of vocal cord surgery is to remove but still preserve the mucosal layer, minimize trauma on the underlying tissues, in order to limit the formation of scars later. To do so, the doctor needs to use microsurgery tools and the manipulation is carried out under a microscope. Most surgeries have good results and postoperative voice quality is reported to be unaffected.
In summary, vocal cord cysts are a relatively uncommon cause of voice changes in the community. The cause of the disease is the accumulation of mucus on the mucosa in the folds. The key to treatment is based on accurate diagnosis, good inflammation reduction and early intervention when indicated.
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