Central

Low pitch with medial margin very visible during eversion

Gospel singer with progressive vocal impairment during singing and a deeper voice for several months.  

Hemorrhagic vocal cord polyp, bilobed, on the right vocal court

Two years ago he developed a hoarse voice. His ENT physician told him that he had vocal nodules and sent him to speech therapy. When I met him, here were his vocal cords. My experience is that a hemorrhagic vocal cord polyp usually is the result of a vocal accident. I don't find that hemorrhagic polyps respond to therapy.

Hemorrhagic vocal cord polyp on the left side with secretions sticking on the right

This is a hemorrhagic vocal cord polyp that came on after a cold and a severe cough in a person who is already very talkative with a bit of a raspy voice. She completely lost her voice for several days before it came back as a very rough voice. This first photo is taken with a Pentax chip endoscope at standard definition.

Right hemorrhagic vocal cord polyp

He woke up one day with a sudden change in his voice sounding like he had re-entered puberty. His voice continued to crack and break up. I noted a right hemorrhagic vocal cord polyp on the endoscopic examination. Three months later his voice had improved on its own.

Bilateral vocal nodules viewed with false color imaging with a Pentax high definition endoscope

This patient noted discomfort with singing. The vocal cord swellings which are also known as nodules require that he hold the vocal cords slightly apart. This allows air leak, impairs his upper vocal range and creates a muscle tension with the resulting discomfort during singing.

vocal nodules

These are vocal nodules in a twentysomething vocal overdoer. She works in the food service industry and frequently sings on the job. The images are taken with a KayPentax 70° rigid endoscope at high definition.