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Head and Neck Cancer

Black Area Near the Vocal Cords

06/21/2010

Question:

I couldn`t breath in January was in the ER twice...all they could say is my soft tissue in my throat had swollen. Went to family doctor he couldn`t find anything. After 3 month my voice was still hoarse...like an up and down with my voice. So went back to my doctor to get refered to an ENT. Found out I have hpyothyriodism, multinodular goiter, acid reflux, and a esophageal hiatal hernia. They decided to do a scope to see my vocal cords last month...very red around the vocal cords and one small gray area near the vocal cord on the left side. They wanted to wait a month and view it again to see if it had improve with meds. So had the scope repeat this month the gray area is now black and tripled in size...they are going to biopsy the area because of the fast growth...what is it the black area? The ENT doctor is scratching his head.

Answer:

Causes for voice issues are not always obvious. You list a few probable cause for your voice issues: hypothyroidism which should be easy to correct, and gastroesophageal reflux disease which is not always easy to diagnose and sometimes frustrating to treat.

In addition you describe a grey area on the vocal cord. Normally the vocal cords have a whitish pink even color. When they are irritated they can change color. The grey could represent an area where the surface is thickened which makes it look whitish or grayish. This could also be secondary to an area of healing covered with a scab. If the area looks bigger on a subsequent exam most often a biopsy is recommended to make sure we are not dealing with a growth. Laryngeal cancer is not very common, and is not a very common cause of voice changes but it needs to be ruled out. I believe your ENT is doing the right things.

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Response by:

Pierre  Lavertu, MD, FRCS(C), FACS Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University