NODULES
Vocal fold nodules are the most common benign vocal fold lesions. They are usually bilateral and occur at the junction of the anterior 1/3 and posterior 2/3 of the vocal folds. Size may vary significantly. Symptoms include hoarseness, breathiness, and lowered pitch.

Voice therapy is often the first step in resolving nodules. In some cases, surgical removal may be appropriate. No matter what the treatment if a singer continues to sing using old habits, nodules may come back.

POLYPS
A vocal fold polyp is a fluid-filled lesion that may occur unilaterally or bilaterally. They may vary in size and are most commonly thought to be caused by vocal abuse or trauma, cigarette smoking, or vocal fold hemorrhage, but the exact cause is unknown. Symptoms often include hoarseness, breathiness, diplophonia (audible perception of two distinct pitches), and stridor (noisy breathing).

A vocal fold polyp usually does not respond to voice therapy. However, therapy to clear the surgical field (reduce swelling and irritation) may be recommended followed by surgical removal.

CYSTS
Vocal fold cysts are fluid-filled growths that may be congenital or acquired. They may appear on only one or both of the vocal folds. Symptoms may include hoarseness, breathiness, and voice and pitch breaks

Vocal fold cysts generally do not respond to voice therapy, and surgical removal will most likely be  recommended depending on the severity of the vocal problem. However, voice therapy pre-surgically to clear the surgical field (reduce swelling and irritation) or post-surgically to address any residual hoarseness may be recommended.

REINKE'S EDEMA
Reinke's Edema occurs when the membranous portion of the vocal folds become filled with fluid.  It may be unilateral or bilateral, and when it becomes very severe, it is often referred to as Polypoid Degeneration.  Risk factors include long-term smoking and chronic vocal overuse or misuse. Symptoms include significantly lowered pitch and severe hoarseness.

Reinke's edema does not generally improve with voice therapy and surgical removal is often recommended.  Pre or post-surgical voice therapy may be recommended.

MUSCLE TENSION DYSPHONIA
Muscle Tension Dysphonia (MTD) is a general term to describe excessive and unnecessary tension of laryngeal muscles during voicing.  MTD is often referred to by many different names including - hyperfunction, functional dysphonia, ventricular or false vocal fold compression, etc.  MTD is often thought to be a compensatory mechanism in the presence of an underlying laryngeal pathology.  Symptoms often include a sensation of excessive laryngeal tension and strain, vocal fatigue, and hoarseness.

The definitive treatment for muscle tension dysphonia is voice therapy with a speech-language pathologist.  Specific vocal exercises will be prescribed to decrease excessive muscular tension with voicing.

HEMORRHAGE
A hemorrhage of the vocal fold occurs when a blood vessel ruptures and bleeds into the submucosal layer of the vocal fold.  A hemorrhage is usually unilateral, but can occur bilaterally, and is usually the result of a single episode of traumatic voice use.  It may also result from a combination of overuse of the voice and taking anticoagulants (e.g., aspirin) or persistent usage of steroidal inhalants.  Symptoms include hoarseness, loss of pitch range and vocal fatigue.

Voice therapy is often recommended to address vocal health and hygiene and to instruct the patient in vocal facilitation techniques targeted at reducing swelling.