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Background and Objectives:Decrease in mucosal waves and diplophonia are known as main diagnostic criteria of vocal cysts. However, preoperative diferential diagnosis of intracordal retention cyst (IRC) over vocal polyp and/or edema is not infrequen-tly challenging even with those criteria. Authors aimed to evaluate the efficacy of laryngeal stroboscopy and acoustic analyses for the proper diagnosis of IRC. Materials and Method:as having IRC either through laryngeal endoscopy or stroboscopy. Endoscopic and/or stroboscopic findings, acoustic and percep-tual parameters were analyzed in comparison to the final pathologic diagnosis. Results:Only 70% of the subjects were correctly diagnosed with laryngeal stroboscopy, which sugested the need of reconsideration of curent diagnostic criteria. Decrease in mucosal waves was a frequently observable but not a specific finding confined to IRC. Diplophonia was neither a comon nor a c changes around the lesion were observed in some of vocal polyps but not in any of IRC. Conclusion:Decreased or absent mucosal wave is one of the characteristics of IRC, but is a not absolute criterion for the differential diagnosis betwen IRC and vocal polyp. Diplophonia and other acoustic parameters are not helpful for the differential diagnosis of those lesions. A careful endoscopic or stroboscopic evaluation of general contour, mucosal change and any surrounding hemorhage will help in the pro-per differential diagnosis of IRC over vocal polyp. Decrease in mucosal waves will also help the diagnosis of IRC but not when (Korean J Otolaryngol 2003 ;46 :862-7)