Vocal Cord Nodules

What are the vocal cords?

The vocal cords are the folds of mucous membrane in the larynx. These thin, reed-like bands vibrate to make vocal sounds during speaking and are capable of producing a vast range of sounds. 

What are vocal cord nodules? 

A vocal cord nodule is a small, inflammatory or fibrous growth that develops on the vocal cords of people who constantly strain their voices. These are also called screamer’s nodule, singer’s nodule and teacher’s nodule. 

What are the symptoms? 

Most commonly, the patient complains of hoarseness. Vocal nodules can also make the voice become breathy-sounding and harsh. 

How is it diagnosed? 

It is important to rule out cancer of the voice box. A video nasopharyngoscopy is often needed to visualize the voice box and determine the cause of the hoarseness.

What causes it?

People who use their voices a great deal, such as professional singers, teachers, auctioneers, lecturers, and salespeople, are prone to have nodules on their vocal cords. Nodules develop as a result of excessive use of the voice. 

It has a structural resemblance to a corn on a toe or a callus on the hand. If one has vocal cord nodules, the voice will become breathy and hoarse. 

Other factors that may cause it include voice overuse, chronic laryngeal allergic reactions and chronic inhalation of irritants, such as industrial fumes and cigarette smoke. 

What is the treatment? 

Treatment requires modification of voice habits, and referral to a speech therapist may be indicated. Resting the vocal cords by allowing little or no speaking for several weeks may permit the nodules to shrink. Children occasionally have screamer’s voice nodules and these can be treated by voice therapy alone. 

Sometimes biopsy and surgical removal are necessary. They can be removed during the course of a special examination (a laryngoscopy) in which a metal tube with a light on the end is passed through the mouth and into the throat. A small, sharp, cup-shaped punch is threaded through the tube and used to clip off the polyps. Biopsy of the nodule may be performed in order to be certain that there is no cancer. Removal of nodule should be followed by voice therapy to correct the underlying cause. 

How can I prevent vocal cord nodules?

  • Properly using the voice to eliminate strain
  • Avoiding screaming and loud talking
  • Speaking in a normal range that is comfortable 
  • Not whispering or speaking at a higher or lower pitch than is natural
  • Releasing neck tension by gently tipping the head forward and to each side while keeping the shoulders down. 

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