Narrow-band imaging involves the use of blue and yellow lights to improve the picture quality of an image and accentuate blood vessel visibility. NBI has been found to help improve visual identification of vocal fold cysts in some cases.Vocal fold cysts can be differentiated from other vocal fold growths as they are usually unilateral. The two types of vocal fold cysts (sub-epithelial and ligament cysts) can be differentiated by colour, size and location. (See section on Types of vocal cord cysts for more information.) If the vocal fold cyst(s) are presumed to be congenital, the patient should have a history of presenting with a hoarse voice.Patients with vocal fold cysts are considered for surgery when presenting with:
Dysphonia
Lack of improvement through voice therapy

Prevention
A key aspect of preventing vocal fold cysts is good vocal hygiene. Good vocal hygiene promotes the healthy use of the vocal apparatus and the avoidance of phonotrauma. Good vocal hygiene practices involve the avoidance of:
Shouting
Whispering loudly or for long periods of time
Frequently of talking over loud background noise
Talking while yawning
Continual clearing of the throat
Speaking in an unnatural voice (i.e. too high or low)
Talking with a cold or laryngitis
Smoking tobacco or marijuana
The consumption of alcohol and coffee
The use of antihistamines, aspirin, steroids, tricyclic antidepressants, or any substance that alters perception (i.e. sleeping pills)
Foul airIn addition, good vocal hygiene involves getting enough rest and drinking sufficient water. 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.
In absolute vocal rest, activities such as talking, whispering, whistling, straining, coughing, and sneezing are restricted. 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. Voice therapy is then required to restore as much function as possible. Post-operative voice therapy may include addressing harmful vocal behaviours, exercises to restrengthen the larynx, and reintegration into normal voice activities. Professional voice users who do not experience substantial limitations due to their cysts may choose to forego surgery. 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. Another option for those who are unwilling to undergo surgery is vocal fold steroid injection (VFSI). Injection of the vocal folds may be done transorally or percutaneously, through the thyrohyoid membrane, thyroid cartilage, or cricothyroid membrane. After VFSI, patients are recommended to take 1 to 7 days of vocal rest. VFSI may also be used to delay surgery, or as a treatment method when the risks associated with surgery are deemed to be too high. Prognosis
Following diagnosis, voice therapy should be implemented to optimize vocal hygiene. Vocal fold cysts tend not to improve solely through vocal rest or vocal therapy.Patients with sub-epithelial cysts have a better prognosis for timely recovery of vocal abilities than patients with ligament vocal fold cysts.