A 45-year-old teacher presents with progressive bilateral vocal cord polyps refractory to voice therapy. Microlaryngoscopic surgery is planned. The surface of a vocal polyp on microlaryngoscopy appears:

• A White, irregular, with contact bleeding
• B Bilateral, symmetrical, hard white nodules at the anterior-middle third junction
• C Smooth, translucent, sessile or pedunculated, arising from the free edge of the cord ✓
• D Granular, firm, hyperaemic lesion at the vocal process

Explanation

Vocal cord polyps are smooth, translucent to haemorrhagic lesions arising from the free edge of the cord, usually unilateral (unlike nodules which are bilateral), resulting from acute vocal trauma or chronic mucosal oedema (Reinke's oedema). Microscopically they contain loose fibrous tissue, dilated blood vessels, or oedema fluid (Reinke's space oedema in polypoid degeneration). White irregular lesions with contact bleeding would suggest leukoplakia or carcinoma.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.