Vocal Fold Lesions, Nodules, Cysts and Polyps

Your vocal folds — or cords — are two flexible bands of muscle tissue that sit at the entrance to your windpipe (trachea).

Vocal fold lesions are one of the most common causes of voice problems. A lesion is an area that is broken or infected. There are three types of vocal fold lesions: nodules, polyps and cysts. 

  • Vocal fold nodules (also called Singer's Nodes and Screamer's Nodes) appear on both sides of the vocal cords. Like a callus, these lesions often disappear when you stop using your voice too much or stop misusing your voice.
  • A vocal fold polyp usually occurs on only one side of the vocal cord. It can occur in different shapes and sizes. A polyp is an extra piece of tissue that grows inside your body. Most polyps are benign (non-cancerous). 
  • A vocal fold cyst is a firm mass of tissue that is contained within a membrane (sac). 

Causes or Contributing Factors

The exact cause of vocal fold lesions is unknown, but there is evidence that they occur after using the voice too much or too harshly. Speaking in an improper pitch, talking a lot, screaming, yelling or talking while you’re sick may contribute to the problem.

Signs and Symptoms

A change in the quality of your voice and constant hoarseness are often the first signs of a vocal cord lesion. Depending upon the size and nature of the nodule, polyp or cyst, you can experience a wide range of voice disturbances.

Other typical symptoms include:

  • Vocal fatigue
  • Unreliable voice
  • Delayed voice initiation
  • Low, gravelly voice
  • Low pitch
  • Voice breaks in the beginning of sentences
  • Airy or breathy voice
  • Inability to sing in high, soft voice
  • Need increased effort to speak or sing
  • Hoarse and rough voice quality
  • Frequent throat clearing
  • Extra force needed for voice
  • Voice is “hard to find”


At the University of Michigan Vocal Health Center, we will:

  • Take a complete history of your voice problem 
  • Evaluate your speaking method
  • Examine your vocal cords

Your U-M physician will also evaluate the extent to which any of these conditions are affecting your voice:

  • Acid reflux disease 
  • Allergies
  • Side effects of medications
  • Hormonal imbalances


The most common non-surgical treatment options for vocal fold lesions include:

  • Voice rest
  • Voice therapy
  • Singing voice therapy

If surgery is needed, the most common surgical treatment option is:

  • Phonomicrosurgery – Phonomicrosurgery is usually performed through a rigid tube called a laryngoscope that is inserted through the mouth. The tube lets the physician see the vocal folds clearly to help make a diagnosis. The physician may use this procedure to remove any diseased tissue or lesions. The use of magnification and delicate instruments makes this possible. Surgery takes about one hour and patients are discharged the same day.

Make an Appointment

Schedule an appointment by calling us at 734-936-8051.