Vocal fold cysts are small, fluid- or keratin-filled sacs that form beneath the surface of the vocal fold. Unlike nodules or polyps, cysts are located deeper in the tissue and typically do not respond to voice therapy alone. Some cysts are congenital (present from birth), while others develop from chronic vocal strain or glandular blockage.

Keratin cysts, also called epidermoid cysts, contain thick, skin-like debris and are usually present from birth or develop after vocal trauma that damages the lining of the vocal fold. These tend to be firmer and more disruptive to voice quality. Mucous retention cysts form when a mucus gland duct becomes blocked—often due to inflammation, reflux, or smoking—and they contain a thinner, watery fluid. Mucous cysts may fluctuate in size and occasionally improve with reflux treatment, but most cysts eventually require surgery.

Common symptoms include hoarseness, a weak or breathy voice, and a loss of vocal clarity or range. We treat cysts with microlaryngoscopy to carefully remove the lesion while preserving surrounding tissue. After surgery, voice rest is followed by therapy to help restore vocal function and prevent scarring. Recovery typically takes about one to two weeks, with gradual voice improvement thereafter.

Cyst