Anterior commissure microweb is a tiny webbing between the vocal cords at the anterior commissure, where the two cords meet. Some think that this can help to cause vocal nodules, but we do not see any such relationship.


Microweb

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Vocal cord swelling (1 of 2)

Subtle vocal cord swellings, mid-membranous cord. This patient also has a microweb, not visible in this view.

Microweb (2 of 2)

Same patient, at closer range, showing the microweb at the anterior commissure.

Capillary Ectasia with Vocal Nodules

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Capillary ectasia with vocal nodules (1 of 2)

Breathing position, note insignificant microweb at anterior commissure.

Capillary ectasia with vocal nodules (2 of 2)

Phonatory position, with poor match of vocal margins.

Nuances “Gleaned” from Daily Examinations

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Vocal "overdoer" (1 of 4)

A vocal “overdoer” with hoarseness. Note broad-based swelling of both vocal cord margins. A microweb, thought to be congenital, is also seen at the arrow. Tiny dots indicate a subtle wrinkle or shallow sulcus.

Inspiratory phonation (2 of 4)

The patient has been asked to produce inspiratory phonation to reveal the translucent polyp and “sulcus,” again at tiny dots.

Translucent polyp (3 of 4)

Under strobe light, the translucence of the polypoid elevation is seen more clearly.

Open phase (4 of 4)

At open phase of vibration again under strobe light, the broad based left vocal cord elevation is also seen.