1.Inappropriate use of sound and excessive use of sound vocal cord vibration in the vocal cord under the mucous membrane blood flow slows down, and sometimes can even stop. If the vibration is intense, blood vessel rupture can occur to form a hematoma. Because the flattened epithelium covering the vocal folds can stretch and not easily ruptured, the hematoma can expand to cause local circulatory disorders in the surrounding tissues, secondary edema, vasodilation, etc. When the hematoma expands to a certain extent, the mucosal movement of the vocal folds is weakened at the base of the hematoma when it vibrates, allowing it to be partially repaired, but inflammatory changes of lymphocytic infiltration can occur. This is the “circulatory disorder-hemorrhage theory”. 2, upper respiratory tract pathology cold, acute and chronic laryngitis, rhinitis, sinusitis, etc. can be used as a trigger for the occurrence of vocal cord polyps. On the basis of the presence of inflammation in the upper respiratory tract abuse of the vocal cords vocalization, prone to vocal cord polyps. 3, smoking Smoking can stimulate the vocal cords, so that the plasma infiltration into the interstitial space of any. 4, endocrine disorders vocal cord polypoid degeneration is mostly seen in menopausal women, may be related to estrogen. Hypothyroidism or hyperthyroidism also has a certain relationship. 5, metaplasia According to the improvement of vocal fold polyps given glucocorticoid treatment and vocal fold polyps seen by light microscopy and electron microscopy histology, some scholars believe that it is related to metaplasia. Pathology Vocal fold polyps are mostly seen at the junction of the vocal folds in front of the edge of 1M3. There are three explanations for this: 1, this is the midpoint of the vocal folds of the membrane, and it is vulnerable to damage when it vibrates with the greatest amplitude; 2, there are vibrating nodules in this area, and it is easy to produce blood flow quiescence and stasis under the epithelium; 3, the distribution and structure of blood vessels in this area are special, and the vocal fold muscles in this area are staggered in the upper and lower directions, and twisting movement can occur when vocalizing, which makes the blood vessels undergo extremely complicated changes. The pathological histological changes of vocal cord polyps are mainly in the subepithelial layer of the mucosa with edema, hemorrhage, plasma exudation, vasodilation, capillary hyperplasia, thrombosis, fibrin deposition, mucus-like degeneration, glass-like degeneration and fibrosis. There may also be a small infiltration of inflammatory cells. Occasionally, it is classified into 3 types: fibrous, vascular and edematous. Symptoms The main symptom is hoarseness, often accompanied by coughing if the polyp is hanging in the subglottic cavity. Huge polyps located between the two vocal folds may cause complete loss of voice and may even lead to dyspnea and wheezing. Examination Laryngoscopy shows a smooth-surfaced, translucent, tipped neoplasm at the anterior-middle 1M3 junction at the edge of the vocal folds. Sometimes there is a broad basal pyknotic polypoid lesion at the free edge of the vocal folds on one or both sides. There are also polyps with diffuse swelling throughout the vocal folds. The polyps are grayish white or light red, occasionally purplish red, and vary in size from green beans to yellow beans. We have seen huge polyps hanging in the subvocal cavity, like purple grapes, with difficulty in breathing in a sitting position, or suddenly blocking the vocal fissure and causing asphyxia. In this kind of huge polyp, the tip is often located in the anterior vocal fold union. Vocal fold polyps are generally unilateral and can occur on both sides at the same time. In a few cases, polyps are found on one side and small nodes on the opposite side. Vocal fold polyps with tips can move up and down with the respiratory airflow, and sometimes are hidden in the subglottis. They are easily missed during examination. Treatment Polyps are removed under indirect or supported laryngoscopy. Especially large polyps requiring laryngectomy are rare. Surgical results are generally good. If no root remains, recurrence is rare. It is important to note that the site of the polyp is also the site of the cancer. Early cancer and early polyps are difficult to distinguish with the naked eye, so the excised polyps should be routinely sent for pathological examination to avoid misdiagnosis. In cases that cannot cooperate under local anesthesia, polyps can be removed by direct laryngoscopy under general anesthesia with tracheal intubation.