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Benign Vocal Cord Disorders Caused by Overuse/Vibratory Injury

A very high percentage of disorders that affect the voice can be termed benign mucosal disorders of overuse or vibratory injury. These injuries are almost always unintended. They occur in persons whose voice use (amount and manner) exceeds the ability of the mucosa to “keep up.” The result is tissue injury.

What Causes Vibratory Injuries?

The classic profile is the talkative and sociable individual whose lifestyle and occupation permits, invites, or requires extensive and sometimes vigorous voice use. One can summarize by saying this kind of person “spends a lot of vocal money.”

Less commonly, a vocal cord vibratory injury can occur as a “fluke” in a person who has a brief episode of extreme voice use—a “screaming argument,” sports event involving extreme voice use, etc.

How Are Vibratory Injuries Treated?

Where possible, vibratory injuries are allowed to heal by managing the amount, manner, and spacing of voice use to “spend less vocal money” for weeks or months while awaiting recovery. Some of these injuries may resolve with this conservative management; others may require surgery (if the patient is sufficiently motivated).

The basic list of vibratory injuries includes  vocal nodules, various kinds of vocal polyps, capillary ectasia, epidermoid cyst, submucosal fibrosis, glottic sulcus, mucosal bridge, and vocal cord hemorrhage.

Vocal injury cartoon YouTube
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An Illustration of Vocal Cord Injury Prevention by Dr. Robert Bastian

When it comes to vocal cord injury, “It is better to build a fence at the top of a cliff than to park an ambulance at the bottom.” Prevention of injury is the point of Dr. Bastian’s tour of a cartoon he had drawn years ago.