Diagnostics
A vocal fold polyp is diagnosed by means of a laryngoscopy, in which the ENT physician can directly or indirectly observe and assess the vocal folds and glottis. A vocal fold polyp then offers him the typical findings described above. In the case of smaller polyps, however, it is sometimes difficult to differentiate them from vocal fold nodules or vocal fold cysts. Other important differential diagnoses are contact and intubation granulomas, which are nodular, inflammation-related tissue growths.
Treatment of vocal fold polyps by surgery
Although there is no danger of malignant degeneration of a vocal fold polyp, these changes are surgically removed due to their symptoms. This removal is carried out microsurgically during direct or indirect laryngoscopy (laryngoscopy of the larynx). Direct laryngoscopy is preferred because it is more gentle on the vocal fold.
The surgical laryngoscope is inserted through the mouth, and the polyp can be removed under the vocal folds using either small instruments (such as a double spoon or small pliers) or a laser device. This operation is usually performed under general anesthesia, but specialized phonosurgeons rarely perform polyp removal under local anesthesia.In order to secure the diagnosis, the tissue removed is then histologically examined in each case, which means that the tissue is specifically assessed under the microscope. After a successful procedure, the patient is cured and the symptoms have disappeared.
A recurrence of vocal fold polyps (recurrence) occurs only in very few exceptions. Since the removal of the vocal fold polyp is a minor procedure, complications are rare. However, like any other procedure, microsurgical removal of vocal fold polyps carries risks.
Bleeding may occur during and after the operation. In addition, swallowing difficulties are not uncommon, as small injuries to the mucous membranes can occur. Pain after the operation, which should disappear after a few days, is rare.
Another risk that occurs in almost all patients after vocal fold polyp removal is hoarseness. In some cases this can persist for up to four weeks after the operation due to possible swelling of the vocal folds. Very rarely the area where the polyp was removed is inflamed.
If bacteria have entered the wound, treatment with antibiotics is necessary. After the endoscopic removal of the vocal fold polyp, patients should not speak for three days. If it is necessary, whispering should be avoided, because whispering puts more strain on the vocal folds.
Patients should speak at a normal volume. If post-bleeding occurs, a doctor should be consulted. In addition, hot and spicy food should be avoided for about a week. Smokers should also stop smoking for at least one week – preferably even longer – because cigarette smoke negatively influences and slows down the healing of wounds.
