Overview
Vocal cord disorders encompass various conditions affecting vocal cord structure and function, including vascular lesions like varix, which can occur in professional voice users due to vocal abuse. 2Diagnosis
Clinical examination revealing characteristic vascular lesions projecting above the vocal cord mucosa.
Endoscopy to visualize submucosal hemorrhages or edematous changes.
Voice assessment for symptoms mimicking nodules or other benign lesions. 2Management
Voice therapy and vocal rest to reduce strain and promote healing.
In cases of recurrent hemorrhages, surgical intervention such as sclerotherapy or laser therapy may be considered.
Monitoring and conservative management for varix without hemorrhage. 2Special Populations
Professional Voice Users: Increased risk of varix due to vocal abuse; careful voice management is crucial. 2Key Recommendations
Utilize transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) combined with laryngeal mask (LM) for microlaryngeal surgeries to potentially shorten PACU stay and improve emergence quality. (Evidence: Moderate 1)
For professional voice users presenting with vocal cord varix, prioritize conservative management including voice therapy and vocal rest, reserving surgical interventions for recurrent hemorrhages. (Evidence: Weak 2)
Regular endoscopic monitoring is recommended for professional voice users to detect early changes indicative of vocal cord disorders like varix. (Evidence: Expert opinion 2)References
1 Wei W, Li X, Feng L, Jiao J, Li W, Cai Y et al.. The effect of intraoperative transnasal humidified rapid-insufflation ventilatory exchange on emergence from general anesthesia in patients undergoing microlaryngeal surgery: a randomized controlled trial. BMC anesthesiology 2023. link
2 Feder RJ. Varix of the vocal cord in the professional voice user. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 1983. link