Vocal fold cysts are fluid-filled, benign lesions located under the surface of the vocal fold mucosa (under the epithelium). Because of the additional mass and stiffness, cysts can cause vibratory disturbances and therefore lead to significant hoarseness.

Once cysts are present they will not resolve or disappear again. Cysts mostly interfere significantly with daily speech and might also cause frequent throat clearing. We recommend phonomicrosurgical removal with high precision instruments. In most cases after adequate microsurgery, cysts will not recur again.

Vocal fold cyst

Surgical removal of a vocal fold cyst

In this case surgical removal is recommended to restore voice function to normal. In other locations, a cyst is often only noticed as an incidental finding and only leads to problems in the event of a significant increase in size. In contrast to changes in the vocal fold epithelium, such as nodules and polyps, vocal fold cyst are localized under the epithelium. Depending on the size of the cyst, it bulges with the epithelium. Sometimes only a slight convexity of the vocal fold is recognizable but the voice sound is worse than visually (laryngoscopically) to suspect. One can only see the “tip of the iceberg”. Voice therapy cannot change the organic findings in the case of a cyst. However, spontaneous rupture of the cyst may occur in the course of the procedure, so the voice may temporarily improve as a result. This effect is usually only temporary, as the cyst can fill up again.

We primarily recommend surgery under general anesthesia. Since the origin of the cyst lies in deeper layers under the epithelium, its permanent removal requires opening the vocal fold and exposing and completely excising the cyst. Even with careful and correct surgery, the cyst may recur.