Clinico-pathological Study of Benign Vocal Fold Polyps and Nodules: A Single Institution Experience of 7 Years at a Tertiary Care Centre, New Delhi, India

Abstract

Introduction: Benign vocal fold polyps and nodules are pseudotumours that are frequently diagnosed in clinical practice, along with other benign pseudotumour conditions like Reinke edema and vocal cord cysts. These lesions are primarily caused by vibratory trauma. The present study aims to explore the clinical and histological differences between benign vocal cord polyps and nodules. Aim: To compare the demographic and clinical profiles, as well as the basic histological changes, and evaluate the concordance between clinical and histopathological diagnoses in vocal fold polyps and nodules. Materials and Methods: This retrospective observational study was conducted in the Department of Pathology at Hamdard Institute of Medical Science and Research, New Delhi, India for a period of six months, from January 2022 to June 2022. Data from the past seven years, from June 2012 to May 2019, were retrieved from the department archives. Biopsies of all cases with vocal fold lesions were processed, and sections were examined under light microscopy. The lesions were comparatively studied based on age, gender, profession, predisposing factors, type of lesion, and presenting symptoms. Basic histological features defining the lesions and the agreement between clinical and histological diagnoses were also studied. Descriptive statistics were used to measure the data. Results: Out of 36 cases, 27 (75%) were diagnosed histopathologically as vocal fold polyps, while 9 (25%) were diagnosed as vocal fold nodules. Among the cases of vocal fold polyps, 14 (52%) were in the above 40-year age group, whereas only 4 (44%) cases of vocal nodules were in the above 40-year age group. Excessive voice abuse was the most common predisposing factor in 21 (58.3%) cases, and hoarseness was the most common clinical manifestation in 34 (94.4%) cases, observed in both types of lesions. There was an agreement of 85% (23/27) in clinical and histological diagnoses of vocal fold polyps and 100% (1/1) in vocal fold nodules. Conclusion: The present study found a higher prevalence of vocal fold polyps compared to vocal nodules. Excessive voice abuse and hoarseness were the most common predisposing factor and clinical manifestation, respectively, in both types of lesions. Thus, the present study highlights the importance of considering various clinical factors and histopathological changes in the accurate diagnosis and management of benign vocal fold polyps and nodules.

Keywords

• epithelial hyperplasia
• hoarseness
• pseudotumour
• vocal abuse