Foreign body caught in the laryngeal ventricle

This 47-year-old female noted hoarseness that started 5-7 years before I saw her. The hoarseness has become progressively worse over the past 2 years. During the past 2 years, she has noted breaks in her voice and an increased effort to make sound.

On endoscopic examination, there was fullness of the right false vocal cord and edematous tissue filling the right ventricle and covering the right posterior vocal cord.

At surgery, after removal of the edematous tissue (which proved to be granulation tissue) with a CO2 laser, there was a dark, irregularly shaped, calcareous mass lightly embedded into the posterior aspect of the right ventricle. I was able to prod the mass out of the ventricle with a suction tip.

3 months after removal, the vocal cords, both true and false had healed completely. I will speculate that a piece of food or other material became trapped in the right ventricle and that calcium from saliva was deposited around the material. Eventually it irritated the tissue enough to cause the granulation tissue to form. As this tissue formed, it gradually put pressure on the vocal cords and dampened the vibration causing the hoarseness and effortful sound production.