Vocal cord growths

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About this video

This lesson looks at growths on the vocal cords that cause hoarseness, seen during laryngoscopy. It covers four types: nodules, which are benign lumps from overuse that often resolve with rest; papillomas, which are benign, caused by HPV and keep growing unless removed; and laryngeal carcinoma, usually squamous cell carcinoma linked to smoking and alcohol, which is aggressive and must be taken seriously. Only a microscope can separate papillomas from carcinomas.

You'll be able to

  • describe how vocal cord nodules form and why they usually resolve on their own.
  • explain why papillomas keep growing and why they need to be removed.
  • explain why a growth other than a nodule must be checked carefully and why microscope examination is needed.

Key words

Laryngoscopy
A procedure that uses a camera on a long tube to see the larynx and the vocal cords.
Nodule
A benign, round lump on the vocal cords caused by overusing the voice, which usually resolves with rest.
Papilloma
A benign growth on the vocal cords, often with an irregular border, that does not go away on its own and needs to be removed.
Laryngeal carcinoma
A cancer of the larynx, most often squamous cell carcinoma, which can grow quickly and is serious.
Benign
Not cancerous, meaning a growth does not spread or invade surrounding tissue as a cancer does.
Transcript

- [Voiceover] So here's a side view of the human head, the throat, and the esophagus. And in the throat you can see we have the trachea right here and we have the larynx, also known as the voice box. And above it we have the epiglottis and the aryepiglottic folds.

So primarily I want to talk about the different causes of hoarseness that can be caused by growths on the vocal cords. And so over here we have a top view of the larynx. So if you were looking directly down at the vocal cords and the larynx, this is the view that you would see.

So this is the front where the epiglottis is, right, the little flap of tissue that protects the airway when swallowing, and this is the back view. And this is the view that's typically seen by practitioners when a patient undergoes laryngoscopy. Laryngoscopy is the use of a camera to visualize the larynx.

The camera is on a very long tube. Also it can be sometimes described as a telescope, to really see what's going on here. It gives a visual of the larynx, or in other words, a visual of the voice box and the surrounding tissue. Now, there are other ways to view the larynx, but this is one of the more common ways, using a fiberoptic scope to visualize everything.

And this usually goes through the nasal passage and down the back of the throat. And sometimes it can be introduced through the mouth as well. So with that, let's go ahead and talk about the different growths that can be seen on the vocal cords. Now, I have these white lines drawn here representing where the vocal cords are.

And here again we have the epiglottis up here and other surrounding tissue on the sides. And the first growth I want to mention is called a nodule. Now, vocal cord nodules are generally bilateral. They can be found on either side. And they just appear as a sort of round lump on the vocal cords.

Now, these nodules form through overuse of the vocal cords. So if a patient is using their voice often, either maybe they're a singer or they talk a lot, kind of like me, it can develop these vocal cord nodules. And they're very irritating, you know. They cause raspiness and hoarseness of the voice and just are overall a nuisance.

But nodules are actually benign, meaning they're not cancerous. And they actually resolve on their own. They'll go away with rest of the vocal cords and rest of the voice. So they resolve on their own. Now, another type of growth is known as a papilloma. And if it's on the larynx, it's called a laryngeal papilloma.

So now let me actually color code these. So nodule I have in pink. Papilloma I'll do in this yellow color. So paillomas kind of just can appear on the vocal cords as a lump also. And they may actually have an irregular border to them, so it may be bumpy. Whereas nodules are for the most part just a little node, kind of like a sphere or a circle, papillomas can grow along the vocal cord.

And as I said, it's a benign growth, meaning it doesn't cause cancer. It's noncancerous. However, they can be very annoying because they do not resolve on their own. In fact, they'll continue to grow unless cut out or excised. And papillomas are generally caused by a virus called HPV, human papilloma virus.

Now, human papilloma virus is caused by oral sex, unprotected oral sex. And these papillomas grow very quickly. And they can be very irritating because even when removed, they can grow back. So the best way to get rid of papillomas is to never have them in the first place.

Safe sex practices is the best way to avoid laryngeal papillomas. And lastly, I'll color in this little blue color is laryngeal carcinoma or laryngeal cancer. Carcinoma means cancer. Very similar to papillomas, they can actually grow in an irregular way on the vocal cords.

So they have very oddly shaped borders. And because papillomas and carcinomas look very similar, they need to be viewed under a microscope because these two types of growth look different under a microscope. Now, most carcinoma of the larynx is called squamous cell carcinoma, also known as SCC, squamous cell carcinoma.

And it's known that both alcohol and smoking can cause squamous cell carcinoma. And as I said, to treat this, this also needs to be excised. However, carcinoma of the larynx, laryngeal carcinoma, is very dangerous and can grow very rapidly. Some patients have to have their entire larynx removed, which means they lose their ability to speak.

So when a patient has a growth other than a nodule on the vocal cords, this should be taken very seriously. However, laryngeal carcinoma is very aggressive, so even cutting it out may not be enough to cure a patient. Some patients have to undergo radiation or chemotherapy along with this.

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