[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Head and neck](https://durgical.com/en/general-pathology/areas/head-neck/) › Benign lesions of the larynx

# Benign lesions of the larynx

- Lesion

Benign laryngeal lesions change the voice: inflammation, nodules from voice strain, and HPV warts that keep coming back in children.

Updated Nov 12, 2026

## Key points

- Croup (laryngotracheobronchitis): parainfluenza virus in young children; subglottic narrowing, barking cough, inspiratory stridor.
- Epiglottitis: Haemophilus influenzae type b (now rare after vaccination), also streptococci and S. aureus; swollen cherry-red epiglottis, drooling, airway emergency.
- Nodules: bilateral, at the junction of the anterior and middle thirds of the true cords; singers, teachers ('singer's nodules'). Polyps: usually unilateral.
- Nodules and polyps: hoarseness; cancer risk is almost nil.
- Squamous papilloma: HPV 6 and 11; solitary in adults, multiple and recurrent in children infected at birth (juvenile-onset papillomatosis); rare malignant change.
- HPV vaccination against types 6 and 11 is lowering papillomatosis rates.

## What it is

The larynx reacts to infection, irritants and voice abuse. Laryngitis is usually viral or from smoke, reflux or overuse; in children, croup and epiglottitis can block the airway. Vocal cord nodules and polyps are reactive lesions of the true cords with almost no cancer risk. Squamous papillomas are benign HPV 6 and 11 tumours that, when multiple and recurrent, form recurrent respiratory papillomatosis.

## Structure

- Laryngitis: mucosal edema and congestion with inflammatory infiltrate.
- Nodule or polyp: smooth, sessile or pedunculated lesion a few millimetres across, covered by squamous epithelium over loose, myxoid or edematous stroma, sometimes with fibrin and hyaline change.
- Papilloma: soft, exophytic, raspberry-like growth with slender finger-like fibrovascular cores covered by orderly squamous epithelium, koilocytes.
- Epiglottitis: markedly edematous supraglottic tissue with neutrophils.

## Step by step

- Repeated vocal trauma and vibration injure the subepithelial (Reinke) space of the cords.
- Edema, fibrin and hemorrhage organise into a nodule or polyp that stops the cords closing evenly: hoarseness.
- HPV 6 or 11 infects basal epithelium (in children via the birth canal) and drives benign papillary growth.
- The virus persists in normal-looking mucosa, so papillomas recur after removal.
- Viral or bacterial infection of the supraglottis or subglottis swells tissue where the child's airway is narrowest.

## Benign laryngeal lesions

| Lesion | Cause | Typical patient | Key feature |
| --- | --- | --- | --- |
| [Vocal cord nodules](https://durgical.com/en/conditions/vocal-fold-nodules-polyps-and-laryngitis/) | Voice overuse | Singers, teachers | Bilateral, symmetric |
| [Vocal cord polyp](https://durgical.com/en/conditions/vocal-fold-nodules-polyps-and-laryngitis/) | Voice trauma, smoking | Adults | Usually unilateral |
| [Squamous papillomatosis](https://durgical.com/en/conditions/recurrent-respiratory-papillomatosis/) | HPV 6 and 11 | Children (also adults) | Multiple, recurrent |
| [Croup](https://durgical.com/en/conditions/croup/) | Parainfluenza virus | Young children | Subglottic swelling, barking cough |
| [Epiglottitis](https://durgical.com/en/conditions/acute-epiglottitis/) | H. influenzae type b, streptococci | Unvaccinated children, adults | Cherry-red epiglottis, drooling |

## Clinical notes

- Hoarseness lasting more than a few weeks warrants laryngoscopy to exclude cancer.
- Child with papillomatosis: repeated surgical removal, risk of airway obstruction and, rarely, spread to the lungs.
- Suspected epiglottitis: do not examine the throat with a tongue depressor; secure the airway.

## Memory aid

Nodules are a pair from the singer's air; papillomas are 6 and 11 that keep coming back.

## Test yourself

Think of the answer, then tap the question to see it.

## How do vocal cord nodules and polyps usually differ?

Nodules are bilateral and symmetric, from chronic voice use; polyps are usually unilateral.

## Which HPV types cause laryngeal papillomas?

Low-risk HPV types 6 and 11.

## Which virus causes most cases of croup?

Parainfluenza virus.

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## Connections

## Related 3

- [Laryngeal carcinoma](https://durgical.com/en/general-pathology/laryngeal-carcinoma/)
- [Sinonasal tumours](https://durgical.com/en/general-pathology/sinonasal-tumours/)
- [Rhinitis, sinusitis, pharyngitis and tonsillitis](https://durgical.com/en/general-pathology/rhinitis-sinusitis-pharyngitis-and-tonsillitis/)

## Related conditions 5

- [Vocal fold nodules, polyps and laryngitis](https://durgical.com/en/conditions/vocal-fold-nodules-polyps-and-laryngitis/)
- [Recurrent respiratory papillomatosis](https://durgical.com/en/conditions/recurrent-respiratory-papillomatosis/)
- [Croup (laryngotracheobronchitis)](https://durgical.com/en/conditions/croup/)
- [Acute epiglottitis](https://durgical.com/en/conditions/acute-epiglottitis/)
- [Laryngopharyngeal reflux](https://durgical.com/en/conditions/laryngopharyngeal-reflux/)

## Microorganisms 3

- [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/)
- [Haemophilus influenzae](https://durgical.com/en/microbiology/haemophilus-influenzae/)
- [Parainfluenza virus](https://durgical.com/en/microbiology/parainfluenza-virus/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [HPV](https://medlineplus.gov/hpv.html) (MedlinePlus, US National Library of Medicine, 2025); [Laryngeal Cancer](https://www.ncbi.nlm.nih.gov/books/NBK526076/) (StatPearls (NCBI Bookshelf), 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/benign-lesions-of-the-larynx/