Strobe of a Vocal Polyp: A Classic Vocal Injury

Today we are going to talk about a pretty common vocal injury, a vocal polyp. 

The story of this patient is pretty classic, it is a story of illness. So this young musical theater performer had noticed some voice changes associated with just a regular cold. She did have to do some voice work during that illness but felt like she had been really careful to work around it and to engage in good technique and breathe support. 

Nonetheless after the illness she noticed that she had some persistent voice changes. 

• Specifically she had noticed a loss of endurance, it was hard for her to sing for as long. 

• Things that should have felt easy for her, her mixed voice, being for her easy, she wasn’t able to access anymore. And the sound quality had changed. 

• She felt a new onset of raspiness and hissing to her voice. She felt like she had to push a little harder to project her voice. 

So when we do the stroboscopy, we get a really nice slow motion view of the vocal cords vibrating. Soon as we enter, we see a significant amount of mucus on the vocal cords and that is already clue 1 that the inflammation from the illness probably hasn’t fully resolved and we are going to have to tackle that. 

As she clears the mucus, which is a really important thing to do during these exams so we see what lies beneath. We see that a polyp has actually formed on the left vocal cord. 

Interestingly, in her case is that the polyp is located a little high off the edge of the cord. That is probably why at times, particularly in her chest register, she is able to close her cords around it because it is up off the edge.  It’s also why, unfortunately, on the higher notes no matter what she does, that polyp is still going to roll in the middle and create almost like a weight effect where she is not going to be able to vibrate as quickly as a high note requires. 

This is absolutely going to disturb the belt and mixed voice, particularly the mixed voice, because the coordination required is often disrupted when there is that kind of a weight on the vocal cord edge. 

In her case she might actually do better because it is such an atypical location for an injury. So we do have a couple of processes in place. We will do some therapy and medical management that might help us avoid surgery. I'll keep you posted as to how she does!