Vocal cord contact ulcers are raw sores on the mucous membrane covering the cartilage to which the vocal cords are attached.
Vocal cord contact ulcers are usually caused by abusing the voice with forceful speech, particularly as a person starts to speak. These ulcers typically occur in singers, teachers, preachers, sales representatives, lawyers, and other people whose occupation requires them to talk or otherwise use their voice a lot. Vocal cord contact ulcers can develop into granulomas (collections of immune cells caused by inflammation).
Backflow of stomach acid (gastroesophageal reflux [GERD]) also may cause or aggravate vocal cord contact ulcers.
Endotracheal intubation (insertion of a plastic breathing tube through the mouth or nose into the windpipe such as may be done during general anesthesia) may cause vocal cord contact ulcers if the tube is too big.
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Symptoms include mild pain while speaking or swallowing and varying degrees of hoarseness.
Diagnosis of Vocal Cord Contact Ulcers
Inspection with a viewing tube
Occasionally biopsy
A doctor makes the diagnosis of vocal cord contact ulcers by examining the vocal cords with a thin, flexible viewing tube (laryngoscopy).
Occasionally, a small tissue sample is removed and examined under a microscope (biopsy) to make sure that the ulcers are not cancerous (malignant) and are not caused by tuberculosis.
Treatment of Vocal Cord Contact Ulcers
Resting the voice
Voice therapy
For gastroesophageal reflux, taking antacids, not eating near bedtime, and elevating the head of the bed
Sometimes, antibiotics
Treatment of vocal cord contact ulcers involves resting the voice by talking as little as possible for at least 6 weeks so that the ulcers can heal. Whispering may cause further injury and must also be avoided.
To avoid recurrences, people who develop contact ulcers need voice therapy to learn how to use the voice properly. A speech therapist can provide such instruction.
For people with vocal cord contact ulcers caused by gastroesophageal reflux, treatment of the reflux helps the ulcers to heal. Measures typically include taking antacids, not eating within 2 hours of retiring for the night, and keeping the head of the bed elevated while sleeping.
Antibiotics can help prevent bacterial infections while the ulcers are healing.
