Scarring of the Vocal Folds
Vocal fold scar is a term applied to a permanent mucosal injury of the vocal fold. This typically involves damage of the very important superficial lamina propria. Scars usually indicates damage severe enough to cause the multiple layers of the vocal folds to be fixed together, losing the ability to vibrate independently. Most often vocal fold scar is the result of laryngeal surgery for precancerous or cancerous lesions. Also, vocal fold scar can result after surgery when voice rest recommendations are ignored, smoking continues, or acid reflux continues uncontrolled or unresponsive to medicine. The hoarseness the results from vocal fold scar is usually rough and can be severe. Often patients need to use so much additional effort to create a voice that they may experience fatigue and pain in the muscles of the anterior neck.
Vocal fold scar causes a disturbance in the vibration of the vocal folds and needs to be evaluated on stroboscopy. Treatment of vocal fold scar is dependent upon the cause and timing. Usually small scars that developed in the setting of carefully controlled laryngeal surgery eventually improve and soften in the voice follows. Surgical intervention for mature scar is difficult because of the difficulty in restoring the normal separation of layers which is critical for normal phonation. Various techniques injectable fillers and injectable medicines have been used in combination to soften the vocal folds and improving the voice. This can be a process requiring a stepwise treatment approach and sometimes months of healing. Also you and your doctor need to follow improvements in your voice with objective measures which include visualization of the vocal folds during vibration and may also include recordings of the voice.