Capillary ectasia in a rock singer with a polyp. The polyp would be the primary cause of any hoarseness or singing impairment because it is on the edge of the vocal cord and prevents closure of the vocal cords. This allows the air to leak out when making sound. The ectasia or capillary lake on the top surface might swell with vocal use as blood accumulates in the dilated capillary. This would make the left cord heavier, causing vocal fatigue and possibly diplophonia.