Contact Ulcers of the Vocal Cords

Contact ulcers are raw sores on the mucous membrane covering the cartilage to which the vocal cords are attached.

Contact ulcers are usually caused by abusing the voice with forceful speech, particularly as a person starts to speak. These ulcers typically occur in teachers, preachers, sales representatives, lawyers, and other people whose occupation requires them to talk a lot. Smoking, persistent coughing, and backflow (reflux) of stomach acid also may cause contact ulcers.

Symptoms include mild pain while speaking or swallowing and varying degrees of hoarseness. A doctor makes the diagnosis by examining the vocal cords with a thin, flexible viewing tube. Occasionally, a small tissue sample is removed and examined under a microscope (biopsy) to make sure that the ulcers are not cancerous.

Treatment involves resting the voice by talking as little as possible for at least 6 weeks so that the ulcers can heal. To avoid recurrences, people who develop contact ulcers need voice therapy to learn how to use the voice properly. A speech therapist can provide such instruction. If the person has acid reflux, treatment includes taking antacids, not eating within 2 hours of retiring for the night, and keeping the head elevated while sleeping.