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Chapters
0:00 Introduction
0:53 Causes of Vocal cord nodules
1:44 Symptoms of Vocal cord nodules
2:01 Diagnosis of Vocal cord nodules
2:40 Treatment of Vocal cord nodules
Vocal cord nodules are bilaterally symmetrical benign white masses that form at the midpoint of the vocal folds.[1] Although diagnosis involves a physical examination of the head and neck, as well as perceptual voice measures, visualization of the vocal nodules via laryngeal endoscopy remains the primary diagnostic method.[2][3] Vocal fold nodules interfere with the vibratory characteristics of the vocal folds by increasing the mass of the vocal folds and changing the configuration of the vocal fold closure pattern.[1][2][4] Due to these changes, the quality of the voice may be affected.[1] As such, the major perceptual signs of vocal fold nodules include vocal hoarseness and breathiness.[4][5] Other common symptoms include vocal fatigue, soreness or pain lateral to the larynx, and reduced frequency and intensity range.[1][4][5] Airflow levels during speech may also be increased.[1] Vocal fold nodules are thought to be the result of vocal fold tissue trauma caused by excessive mechanical stress, including repeated or chronic vocal overuse, abuse, or misuse.[1][2][5] Predisposing factors include profession, gender, dehydration, respiratory infection, and other inflammatory factors.[1][2]
For professional voice users as well as individuals who frequently experience hoarseness, vocal hygiene practices are recommended for the prevention of vocal fold nodules and other voice disorders.[6] Vocal hygiene practices include three components: regulating the quantity and quality of voice use, improving vocal fold hydration, and reducing behaviours that jeopardize vocal health.[6] About 10% of nodules resolve on their own, which is more likely if they are smaller and the onset more recent.[7] Treatment of vocal fold nodules usually involves behavioural intervention therapy administered by a speech-language pathologist. In severe cases, surgery to remove the lesions is recommended for best prognosis.[8][9] In children, vocal fold nodules are more common in males; in adults, they are more common in females.[10][5]