MICROVASCULAR LESIONS OF THE TRUE VOCAL FOLD

Microvascular lesions, also called varices or capillary ectasias, in c ontrast to vocal fold polyps with telangiectatic vessels, are relative ly small lesions arising from the microcirculation of the vocal fold. Varices are most commonly seen in female professional vocalists and ma y be secondary to repetitive trauma, hormonal variations, or repeated inflammation. Microvascular lesions may either be asymptomatic or caus e frank dysphonia by interrupting the normal vibratory pattern, mass, or closure of the vocal folds. They may also lead to vocal fold hemorr hage, scarring, or polyp formation. Laryngovideostroboscopy is the key in determining the functional significance of vocal fold varices. Man agement of patients with a varix includes medical therapy, speech ther apy, and occasionally surgical vaporization. Indications for surgery a re recurrent hemorrhage, enlargement of the varix, development of a ma ss in conjunction with the varix or hemorrhage, and unacceptable dysph onia after maximal medical and speech therapy due to a functionally si gnificant varix.