11/13/2025
Let’s talk about where and why lesions form on the vocal folds 🎤, because their location tells you a lot about their underlying cause 🧠.
Granulomas typically form at the posterior glottis, right around the vocal processes of the arytenoid cartilages . This region does not vibrate the same way the membranous folds do. Instead, it is a site of contact pressure 💥, especially during phonation patterns that cause hard glottal attack, chronic throat clearing, coughing 🤧, or irritation from intubation or reflux. The tissue response here is inflammatory and protective, leading to the formation of a granuloma.
By contrast, nodules and polyps occur along the membranous portion of the vocal folds, particularly in the mid-membranous region, the point of greatest amplitude during vibration 🎶. This is the striking zone where repetitive collision forces between the folds cause epithelial injury, swelling, and, over time, the development of benign lesions like nodules or polyps.
So while granulomas and nodules can both affect voice quality 🎵, their anatomic sites and mechanisms are distinct. Granulomas reflect contact and inflammation at the posterior glottis 🔹, and nodules and polyps reflect vibratory trauma at the mid-membranous folds ⚡.
Understanding this difference is key to writing accurate reports and referring to appropriate medical professionals for further work up. 🗝️
💡Remember though, speech pathologists cannot diagnose vocal fold/laryngeal anomalies. We can only describe what we see and refer 💡
