A 45-year-old female singer notices progressive dysphonia over 6 months. Laryngoscopy shows bilateral symmetrical pedunculated swellings at the junction of the anterior and middle thirds of both vocal cords. She reports voice abuse and acid reflux. These lesions are BEST described as:

• A Vocal cord polyps — unilateral, broad-based hemorrhagic lesions
• B Reinke's edema — diffuse gelatinous submucosal edema of the entire cord
• C Laryngeal papillomatosis — multiple warty lesions throughout the larynx
• D Vocal cord nodules (singer's nodes) — bilateral mirror-image swellings at the maximum contact point due to phonotrauma ✓

Explanation

Vocal cord nodules (also called singer's nodes, screamer's nodes, or teacher's nodes) are bilateral, symmetrical, small firm swellings at the junction of the anterior one-third and posterior two-thirds of the true vocal cords — the point of maximum vibratory trauma during phonation. They are caused by voice abuse/overuse, creating squamous metaplasia and fibrous tissue at the contact point. Treatment is voice therapy first; surgery for persistent cases. Polyps are typically unilateral and larger. Reinke's edema is diffuse. Papillomatosis is multifocal/warty.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.