However, certain features visible on a non-stroboscopic evaluation may suggest scar. For this reason, scar is one of the most often overlooked problems in laryngology. Any laryngoscopy under normal light, whether with a flexible or rigid endoscope, cannot accurately assess scar. What does vocal fold scar look like?īecause scarring causes disturbances in vibration, it is usually visible only on stroboscopy. Scarring does not usually cause difficulty swallowing or breathing. In general, hoarseness from scarring becomes worse over the course of a day’s voice use, and a little better with voice rest. When the mucosa does not vibrate readily, voice production requires more effort, which can result in a strained voice quality, and many people report soreness or tightness of their neck muscles as a result. The degree of hoarseness is roughly proportional to the extent and severity of the scar.

Hoarseness results from abnormalities in vibration caused by scarring. What are the symptoms of vocal fold scar? The bloodshot, unusually white vocal folds shown here are typical 'diffuse scarring' - in this case after sloppy surgery for a pair of vocal fold polyps. Scar is very difficult to show in still images. Most laryngologists agree that quitting smoking, controlling reflux, and not using your voice immediately after surgery are helpful. The risk of scar, as well as measures to take to prevent scar, should be discussed with your doctor. The probability of scar varies from operation to operation, but is usually small in cases of surgery for benign lesions. Scar may also result from damage to the larynx from disease, accident, or severe voice overuse.Ī scar is a possible after any surgery of the vocal fold. Scar usually results from surgery - and may be unavoidable, as when an invasive cancer must be removed - or it may represent a complication. Sometimes, scarring is severe enough to cause outright fixation of the epithelium to deeper tissues. Damage to this layer causes the covering of the vocal fold to be less pliable than it needs to be. Vibration of the lining (epithelium) of the vocal fold depends on the integrity of the layers underneath it, particularly the superficial lamina propria, a loosely-packed network of fibers that functions like a 'ball bearing' layer to guarantee that the epithelium on top of it is flexible and not tightly attached to the deeper tissues (see Normal Voice Function). Scar refers to damage to the vibratory tissues of the vocal fold.

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Surgery for deeper voice