Which feature is typical of true vocal fold pathology due to reflux?

• A. Edema and erythema of the laryngeal mucosa, including the true vocal folds, with thick mucus.
• B. Cysts on the false vocal folds.
• C. Atrophy of the vocal folds.
• D. Calcified nodules on the true vocal folds.

Answer: (A)

Reflux irritates the laryngeal mucosa, producing chronic inflammatory changes that involve the true vocal folds. This typically presents as edema and erythema of the laryngeal mucosa, often with a thick, mucoid coating. The swelling and redness reflect acid irritation, and the thick mucus is a common accompanying feature that can further disrupt vocal fold vibration, leading to hoarseness.

Cysts on the false vocal folds are not driven by acid irritation and reflect a different, non-reflux pathology. Vocal fold atrophy is a degenerative or disuse change rather than an inflammatory response to reflux. Calcified nodules on the true vocal folds stem from long‑standing phonotrauma or aging, not from reflux-related inflammation.