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Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts

Johns, Michael M.

Current Opinion in Otolaryngology & Head and Neck Surgery: December 2003 - Volume 11 - Issue 6 - p 456-461
Laryngology and bronchoesophagology

Purpose of review Innovative otolaryngologists, speech language pathologists, and voice scientists have continued to advance our understanding of the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. This article reviews the recent publications over the past 3 years with respect to these advances.

Recent findings Support for the notion that benign vocal fold lesions arise from phonatory trauma and vocal misuse continues to become evident. Changes in the molecular characteristics of the lamina propria in these lesions are beginning to be understood. For diagnostic purposes, the use of innovative technology such as ultrasonography and virtual laryngoscopy is being explored. Continued support for behavior modification as a primary treatment modality for benign vocal fold lesions has been published, and refinements in technical aspects of laryngeal microsurgery persist. Finally, outcomes studies have demonstrated improvements in vocal disability with both behavioral and surgical interventions.

Summary Clinical and basic research has furthered our understanding of benign vocal fold lesions and has expanded our diagnostic and therapeutic armamentarium for patients with dysphonia arising from these lesions.

Department of Otolaryngology–Head and Neck Surgery, Emory University, Atlanta, Georgia, USA

Correspondence to Michael M. Johns, MD, Emory University, 550 Peachtree Street, 9th floor, Suite 4400, Atlanta, GA 30308, USA

Tel: 404-686-1850; fax: 404-686-4699; e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.