Functional trauma of the vocal folds: classification and management strategies.

Laryngeal trauma may result from accidents, surgical, iatrogenic and functional lesions. Functional trauma is caused by excessive and improper use of the voice and may affect the speaking voice of nonprofessionals, but also the speaking and singing voice of vocal professionals. According to specific etiologic, histologic, laryngoscopic and stroboscopic features various vocal fold changes are included in the functional traumatic group. These are mucous standing, 'nodule-like' lesions (contact edema, contact thickening and vocal nodules), polyps, hematoma, cysts and contact hyperplasia. Management strategies are discussed for each lesion, including drug therapy, voice reeducation and phonosurgery.