Vocal Fold Scar
Vocal fold scar is stiffness of the soft vibrating layer of the vocal fold. The fold can still move, but its edge no longer ripples freely, so the voice becomes rough, breathy and effortful.
What it is
The vibrating layer of the vocal fold is a delicate, gel-like tissue. When it is injured and heals with scar, it loses that pliability. The result is a segment of the fold that vibrates poorly, often with a gap between the folds on closing.
Causes
Previous vocal fold surgery, a vocal fold haemorrhage, severe or repeated inflammation, radiotherapy, and intubation injury are the commonest causes.
How it is diagnosed
Stroboscopy shows the stiff segment and reduced mucosal wave. The history, including any previous surgery, helps explain it.
Treatment
Scar is among the harder problems in laryngology, and we are candid about that. Voice therapy helps the voice work efficiently with the tissue available. In-office steroid injection can improve pliability in selected patients; augmentation injection can reduce a gap; surgery is considered in selected cases. Regenerative treatments are under investigation. We give an honest expected range rather than a single promised outcome.
Medically reviewed by
Associate Professor Necati Enver, MD
Laryngologist · Founder and Director, Istanbul Voice Center · Reviewed September 2026
General information only. It does not replace an individual assessment. Medical disclaimer
Frequently asked questions
What causes vocal fold scar?
Scar can follow surgery on the vocal folds, a haemorrhage, severe or repeated inflammation, radiotherapy, or intubation injury. In some patients no clear cause is found.
Do steroid injections help vocal fold scar?
In-office steroid injection can improve the voice in selected patients with scar. The duration of that response has been studied by the institute's director and colleagues, and results vary between patients.
Can scar be removed?
Scar cannot simply be removed without creating new scar. Treatment aims to improve pliability and closure, and to help the voice work efficiently with the tissue that remains.
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