What are they?

  • Papillomas are benign growths. They do not become malignant.
  • They occur mainly on the vocal folds but they can also appear in the larynx.
  • They can occur as a single papilloma or in clusters like warts.
  • In the same way that warts are caused by a virus, it’s thought that a virus also causes papillomas. The specific virus hasn’t yet been identified but it’s thought that the human papilloma virus is the cause.
  • Papillomas can occur in children and adults.
  • They occur more frequently in men than women.

Is there a cure?

  • Not as such, although there are a number of options for treating them (see below).
  • Unfortunately, once papillomas have been removed they can recur. It’s not possible to predict how quickly they might recur and adults can have long intervals between occurrences. In severe cases this interval can be shorter.

Treatments

Many forms of treatment have been used to remove papillomas, such as surgery, drug therapy and antibiotic therapy. Currently, traditional surgical removal of the growths and another technique, carbon dioxide laser surgery, are both used. Carbon dioxide laser surgery uses intense laser light as the surgical tool. Your ENT surgeon will be able to discuss the options open to you.

Your voice

Hoarseness is the first sign of papilloma recurrence (but remember that hoarseness can also be caused by common colds and flu).

How effective is voice therapy?

  • This depends to some extent on how smooth your vocal folds are. Like warts, the papillomas make the surface of the vocal folds uneven and so they may not be able to close with a perfect seal. If you’ve had surgery, as with any surgery where the body is cut, there may be some scarring on the vocal folds. This may mean that they can’t move quite as freely as before.
  • It’s important to eliminate any possible vocal abuse, such as the following:
  • frequently clearing your throat
  • excessive coughing
  • yelling, screaming and shouting
  • loud laughing
  • smoking
  • drinking an excess of alcohol, particularly spirits
  • environmental pollution, e.g. dusty environment
  • making strange noises or doing impersonations
  • excessive talking
  • talking too loudly
  • talking in a noisy environment
  • talking with an infection, e.g. cold, sore throat
  • talking too high or low
  • singing too high or low
  • Your voice therapist will discuss with you ways of reducing possible vocal abuse.
  • Sometimes, people with papillomas get into the habit of pushing their voices too hard in an effort to make it sound clearer. Your voice therapist will show you ways of speaking in an easy relaxed manner, without putting too much strain on your voice.

References

Mathieson, L. (2001) Greene and Mathieson’s the Voice and its Disorders (6th edn) London: Whurr Publishers Ltd.

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