Histopathological aspects of benign vocal fold lesions associated with dysphonia

Functional dysphonia is not usually accompanied by structural organic changes of the vocal folds. It is, however, possible that longstanding functional voice disorders may ultimately lead to organic pathological lesions of the larynx.” Vocal nodules, polyps, contact granuloma, Reinke's edema, and polypoid degeneration are examples of these lesions. Damsté and Lerman” and Arnold'considered vocal abuse and mis-use as the prime factors in the causation of these lesions. These improper vocal habits may trigger the vocal mechanism to set a defensive reaction leading to these vocal fold changes. Vocal fold polyps, vocal nodules, polypoid degeneration, and laryngeal cysts are classified by Stewart" and Holinger and Johnston'under benign tumors of the larynx. This classification is based upon the gross appearance of these masses more than upon their histological picture. Such lesions are nevertheless generally classified under chronic laryngitis. That is to say, it is an inflammatory phenomenon where infection plays a role, together with vocal abuse and environmental irritants, in the pathogenesis of these lesions.” Because of these contradictory views on the pathogenesis of these lesions this work is devoted to the study of such benign small vocal fold lesions, utilizing a battery of clinical voice investigations as well as histopathological diagnostic classification and categorization of these lesions.