The larynx is lined with mucous glands that keep the vocal cord surface lubricated. When these glands become plugged, they can swell into cysts that push against the vibrating edge of the cord — stiffening it, creating a bump, and silencing the voice much like a polyp does. The same sac-like structures (saccules) that normally hold mucus can also herniate upward into the false vocal cord, or even out into the neck. And sometimes mucus itself becomes the problem: sticky secretions that accumulate wherever vibration is impaired.
◆ Vocal Cord Cyst
John Sackett’s cystic swelling within the right vocal cord created stiffness and prevented closure — the hallmark of a plugged mucous gland. Unlike nodules, vocal cord cysts can appear anywhere along the cord’s length, not just at the midpoint.
◆ Saccular Cyst
Barry Black’s two large hemispheric masses sat on the underside of the false vocal cords. Every time he squeezed his cords together to produce sound, they rubbed against the true vocal cords — increasing effort with every attempt to speak.
◆ Laryngocoele
Desnea Winston, a decades-long smoker with severe COPD, had essentially inflated her own left saccule with the effort of breathing. The resulting air-filled cyst rolled over her vocal cords during phonation and nearly silenced her voice completely.
◆ Thick Mucus
More often than actual mucosal disease, secretions accumulate where vibration is already impaired. For the dedicated examiner, thick mucus on the vocal cords acts as a divining rod — pointing directly to where the underlying lesion will be found.