Abstract
Benign vocal fold lesions are a common cause of dysphonia and are frequently seen by otolaryngologists. There exist no widely accepted definitions or nomenclature for benign vocal fold lesions. This results in great difficulty in otolaryngologists discussing the diagnosis and treatment of these lesions with patients and colleagues. Given that some names used to describe vocal fold lesions are often unique to either a specific group of otolaryngologists or the otolaryngologist's training (ie, podule), much confusion exists regarding the diagnosis, treatment, and outcome results of benign vocal fold lesions. To further the confusion, often a single name (nodule) is used by an otolaryngologist to discuss several different pathologic entities (cyst, polyp, scar, etc). As a result, it is common for one otolaryngologist's “vocal nodule” to be another's “vocal fold cyst” and another's “vocal fold polyp.” These problems severely limit the ability for communication, education, and research in this area of otolaryngology. Since there is no “common language” for the discussion of the diagnosis and treatment of benign vocal fold lesions, otolaryngologists and patients struggle to make sense of these conditions. Treatment methods and prognosis following treatment are often different between different benign lesions of the vocal folds (voice therapy vs surgery). Thus there is a significant need for a unifying nomenclature paradigm of benign vocal fold lesions, specifically mid-vocal fold lesions. This miniseminar has several objectives regarding the nomenclature of benign mid-vocal fold lesions: (1) to describe and illuminate the present problems associated with the lack of a unified nomenclature system; (2) to propose and describe in detail a nomenclature system for benign mid-vocal fold lesions; and (3) to demonstrate the utility of the proposed nomenclature system, clinical cases will be presented and discussed among the panel and the audience. The panel members have a great amount of experience in the field of voice disorders and have been selected based on their expertise, experience, and diverse training backgrounds. The individual panelists will participate by sharing their problems and insight with past nomenclature issues and present clinical cases that will be classified with the proposed system. A unified vocal fold lesion nomenclature system will be presented including a clinically applicable diagnostic paradigm. Each vocal fold lesion in the paradigm will be defined in terms of presentation appearance, stroboscopic features, and response to treatment. The clinical components of the nomenclature system include vocal fold morphology, stroboscopic features, response to voice therapy, and operative findings. These “defining criteria” will be presented and reviewed in detail using a case presentation format. Lastly, time will be reserved for questions and answers from the audience regarding the application of the proposed vocal fold lesion nomenclature and classification system, which may result in future modifications and greater applicability and acceptance of the nomenclature system.