Vocal fold nodule

Vocal fold nodules are small, benign (non-cancerous) growths on both vocal cords that are often caused by vocal abuse. Vocal fold nodules are also known as singer's nodules, screamer's nodules, or teacher's nodules, as these professions typically require prolonged or intense voice use. Over time, this excessive voice use leads to repeated trauma to the vocal fold tissue, resulting in the formation of these nodules.

Causes

The primary cause of vocal fold nodules is chronic misuse or overuse of the voice. This can include yelling, loud singing, or speaking in a loud or strained voice for extended periods. Other contributing factors may include smoking, allergies, acid reflux, and respiratory infections, which can further irritate the vocal cords.

Symptoms

Common symptoms of vocal fold nodules include:

• Hoarseness
• A breathy voice
• A rough, scratchy voice
• Vocal fatigue
• Limited vocal range
• Pain in the throat or neck
• The sensation of a lump in the throat

Diagnosis

Diagnosis of vocal fold nodules typically involves a thorough history and physical examination by an otolaryngologist (ear, nose, and throat doctor). Visualization of the vocal folds is usually accomplished using a procedure called laryngoscopy, which allows the doctor to examine the structure and motion of the vocal cords directly.

Treatment

Treatment for vocal fold nodules usually involves a combination of voice therapy, behavioral changes, and, in some cases, surgery. Voice therapy with a speech-language pathologist is often the first line of treatment. This therapy focuses on teaching the patient healthy voice use habits to reduce the strain on the vocal cords. Behavioral changes, such as avoiding yelling or whispering, staying hydrated, and maintaining good vocal hygiene, are also recommended. In severe cases, or when nodules do not respond to conservative treatment, surgical removal may be considered.

Prevention

Preventing vocal fold nodules involves taking care of the voice and avoiding behaviors that can lead to vocal strain. Recommendations include:

• Staying hydrated
• Avoiding excessive yelling or speaking loudly
• Taking vocal breaks during prolonged periods of speaking or singing
• Using a microphone when speaking to large groups
• Avoiding smoking and exposure to secondhand smoke
• Managing acid reflux or allergies, if present

See Also

• Vocal cord paresis
• Laryngitis
• Voice therapy