Vocal fold nodules and cysts are benign (noncancerous) growths that can affect people of all ages. Although their symptoms are similar, their cause and treatment usually differ. Cysts and nodules also differ in their location on the vocal fold. Nodules most often occur simultaneously on both sides and are found at the junction of the front and middle third of the free edge of the vocal fold. Cysts are usually one-sided and can occur anywhere on the fold.
The image below is a view of vocal fold nodules (yellow arrows).
Symptoms: The most common symptom of nodules and cysts is hoarseness. Occasionally, a growth will become large enough to cause shortness of breath.
Causes: Nodules typically occur as a result of voice misuse or overuse, which causes irritation and inflammation of the vocal fold mucosa. With continued misuse, the tissue becomes scarred and hardened. Cysts, on the other hand, are usually the result of a blocked mucous gland within the fold. As mucous accumulates behind the blockage, the tissue expands and a cyst is produced. Some cysts occur at the time of birth and may present with symptoms years later.
Treatment: Because nodules usually occur as a result of improper voice use, the initial treatment is generally voice therapy. The patient is taught how to avoid behaviors that may cause or aggravate the formation of nodules. If this treatment fails, surgery may be necessary to remove the nodules. Cysts are usually treated by surgical removal.
Although recurrence is a concern, treatment for both nodules and cysts is usually successful, and normal voice function returns.