Vol. 9, Issue 4, Part B (2025)

Background: Benign vocal cord lesions represent a common cause of persistent hoarseness and significantly affect voice quality and daily functioning. Microlaryngeal surgery is a well-established therapeutic approach; however, outcomes vary depending on lesion type and patient characteristics. This study aimed to evaluate the clinical outcome of microlaryngeal surgery in the management of benign vocal cord lesions. 
Method: A prospective study conducted over 18 months, from June 2012 to December 2013. Department of Otolaryngology, Al-Yarmouk Teaching Hospital, Baghdad, Iraq. A total of 61 patients presenting with hoarseness were evaluated. Only patients diagnosed with apparently benign laryngeal lesions were included, while non-operative cases and any clinical suspicion of malignancy were excluded. All patients underwent indirect laryngoscopy and/or flexible nasopharyngoscopy, followed by direct laryngoscopy under an operating microscope. Data collected included demographic characteristics, occupational categories, anatomical site of involvement, histopathological findings, and postoperative outcomes. 
Results: Benign vocal cord lesions were most common in the active working-age group (21–40 years). Seven major categories of benign lesions were identified: polyps, nodules, Reinke’s edema, intracordal cysts, granuloma, solitary papilloma, and multiple papillomatosis. Males were more commonly affected than females (55% vs. 45%), with a male-to-female ratio of 1.2:1. Polyps were the most frequent lesion (32.5%), followed by nodules (25%). Teaching staff accounted for the highest occupational category (25%), followed by housewives (22%). After microlaryngeal surgery, 70% of patients achieved complete symptom resolution, 25% showed partial improvement, and 5% experienced recurrence. 
Conclusion: Microlaryngeal surgery is highly effective for most benign vocal cord lesions, with excellent symptomatic improvement and low recurrence. Recurrent respiratory papillomatosis remains the main exception, often requiring repeated interventions.