Vocal fold cysts are diagnosed based on gathering a case history, perceptual examination, and laryngeal imaging.

[4] Initial treatment of the cysts involves voice therapy to reduce harmful vocal behaviours.

[2] They are typically found in the middle portion of the upper lamina propria of the vocal folds.

[11] A medical and voice history can help distinguish patterns of misuse and phonotrauma to assist in diagnosis.

[11] Further, videostroboscopy tends to show increased submucosal swelling in the affected areas of the vocal fold(s)[9] More recently, other technologies have been introduced to assist with obtaining imaging of the vocal folds, including the use of Narrow-band imaging (NBI.

[12] NBI has been found to help improve visual identification of vocal fold cysts in some cases.

If the vocal fold cyst(s) are presumed to be congenital, the patient should have a history of presenting with a hoarse voice.

[4] It is important to keep the vocal fold tissue healthy and hydrated, and when possible to limit the quantity of speaking in order to avoid damage.

[15][16] Vocal fold cysts are most responsive when surgical intervention is supplemented with voice therapy.

[15] Vocal fold tissue can be preserved during surgery by raising a micro-flap, removing the cyst, then laying the flap back down.

[19] Congenital ductal cysts (those caused by blockage of a glandular duct) may be treated by marsupialization.

[2] In absolute vocal rest, activities such as talking, whispering, whistling, straining, coughing, and sneezing are restricted.

[21] Once adequate healing has occurred, the patient may be transitioned to relative vocal rest, which typically involves 5 to 10 minutes of breathy voicing per hour.

Professional voice users who do not experience substantial limitations due to their cysts may choose to forego surgery.

[8] Considering that some cysts remain stable over long periods of time, voice therapy alone may be an option for those who are resistant to surgery.

[15] Another option for those who are unwilling to undergo surgery is vocal fold steroid injection (VFSI).

[2] Up to 20% of patients show scarring, polyps or vascular changes of the vocal folds following surgery.