Anatomy of the Condition

The vocal folds (or cords) are inside the larynx or voice box. These structures open for breathing. They come together during swallowing. They vibrate as air passes between them during speaking or singing. Fine layers with a soft outer cover make up the vocal folds. A stiffer ligament lies below the thyroarytenoid muscle, connecting deep to the ligament. The thyroarytenoid muscle makes up the bulk of the vocal fold.

Vocal fold scarring results in fibrous tissue replacing normal tissue. This reduces the vibration of the vocal folds that allows for a clear voice.

Causes or Contributing Factors and Symptoms

Injury, trauma or systemic diseases can cause vocal fold scarring.

The symptoms can include:

  • Hoarseness
  • Rough or scratchy voice
  • Vocal fatigue and strain
  • Increased vocal effort
  • Vocal onset delays
  • Day-to-day variablitity in the voice
  • Loss of upper range in singing
  • Difficulties with vocal register changes in singing

Diagnosis of Vocal Fold Scarring

Our team will discuss your symptoms and medical history. We will perform a thorough head and neck examination. Our evaluation team often involves several members of the Emory Voice Center. We will assess vocal quality, efficiency, and proper speaking technique.

We may complete a laryngeal videostroboscopy. In this minimally invasive procedure, we use an endoscope (a small tube equipped with a fiber optic camera.) A stroboscopic light source lets us check laryngeal function and vibration.

We may recommend microlaryngoscopy. A physician will examine the vocal folds of the larynx with magnification tools. We conduct this procedure under general anesthesia.

Treatments

Treatment for vocal fold scarring begins with rest and medication to reduce inflammation. We will recommend preventive measures to stop further inflammation. We may recommend surgery. Options include fat injection laryngoplasty and other procedures to attempt voice improvement.