Saturday, August 12, 2023

Vocal cord pearl? - Diagnosis?

Scenario: As you are intubating a patient you visualize the following picture.



Answer: Vocal Fold Polyp

A vocal fold polyp is a fluid-filled lesion that may occur unilaterally or bilaterally. They may vary in size and may be either "sessile" or pedunculated". They are most commonly thought to be caused by vocal abuse or trauma, cigarette smoking, or vocal fold hemorrhage. Vocal characteristics often include hoarseness, diplophonia (audible perception of two distinct pitches), and stridor (noisy breathing). A vocal fold polyp though usually require surgical removal but conservative and speech therapy can be tried.

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References:

1. Vasconcelos D, Gomes AOC, Araújo CMT. Vocal Fold Polyps: Literature Review. Int Arch Otorhinolaryngol. 2019 Jan;23(1):116-124. doi: 10.1055/s-0038-1675391. Epub 2019 Jan 14. PMID: 30647795; PMCID: PMC6331298.

2. Jeong WJ, Lee SJ, Lee WY, Chang H, Ahn SH. Conservative management for vocal fold polyps. JAMA Otolaryngol Head Neck Surg. 2014 May;140(5):448-52. doi: 10.1001/jamaoto.2014.243. PMID: 24676626.

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