Phonotrauma and Voice Diseases

Benign diseases of the vocal cords are largely caused by repeated vocal cord trauma (phonotrauma). Examples of these diseases are vocal cord nodules, vocal cord polyps and Reinke's oedema. After phonotrauma, damage occurs to the lamina propria or basement membrane under the surface (epithelium) of the layered structure of the vocal cords. During the repair of this damage, the following pathologies occur.

Phonotrauma and vocal cord polyps

Vocal cord polyps are primarily caused by voice misuse and result in subepithelial haemorrhage, haematomas following haemorrhage and resolution of the haematoma through inflammation and fibrosis. Histological examination may reveal haemosiderin and iron deposits in the lamina propria.

Vocal Cord Nodules

Vocal cord nodules are the result of inappropriate voice use that causes excessive vibration of the vocal cord mucosa. In vocal cord nodules, there is excessive fibronectin deposition in the lamina propria following rupture of the basement membrane. Rupture of the basement membrane often occurs at the junction of the anterior 1/3 and middle 1/3 of the vocal cords and these parts are subjected to tearing forces during phonation.

Phonotrauma and Reinke's oedema

Reinke's oedema is swelling of the entire vocal cords, not a specific area. It usually occurs as a result of chronic irritation in patients who smoke and overuse or misuse the voice.

Treatment of Voice Disorders

Once these lesions develop on the vocal cords, the character and quality of the voice is affected. Initially, the lesions prevent complete closure of the vocal cords, disrupting their vibration dynamics. Mucosal wave movements in the vocal cords are impaired, whether they move up and down or inwards and outwards. Producing sound, speaking and singing despite existing lesions permanently affects the harmonious movement of the vocal cords. These vocal cord disorders can be completely cured using one or more of the following methods: medical treatment, phonon microsurgery and voice therapy.