Vocal Cord Nodules: Causes, Symptoms, and Treatment

By tagore admin
Posted January 15, 2025

Vocal Cord Nodules: Causes, Symptoms, and Treatment

What are vocal cord nodules?

Vocal cord nodules are non-cancerous lesions which arise on the surface of the vocal cords due to vocal stress or overuse. One frequently encounters persons who speak or sing in a loud voice-a teacher, a singer, or a public speaker-with this disorder. The nodules are like calluses forming on the anterior border of the vocal cords, leading to swelling, thickening, or stiffening of the tissues.

Such changes can bring about a hoarse or raspy voice with vocal fatigue. In extreme cases, the nodules can disrupt normal vibratory oscillation of the vocal cords, thus hampering speech or singing. Management typically entails vocal rest, voice therapy, and may involve surgery if the nodules persist or severely impair vocal function.

Are vocal cord nodules serious?

Vocal cord nodules may not really seem too serious in nature, since they are benign. However, should they remain untreated, they could definitely cause discomfort or significant impairment of vocal function.

If vocal cord nodules are ignored, they could contribute to prolonged hoarseness, voice fatigue, or even discomfort that may interfere with how a person speaks or sings. In more extreme cases, this may cause frustration and interfere with one’s livelihood and/or social life.

Most cases resolve with treatment, which includes voice therapy or voice rest. If the cases become severe, they might require surgical intervention for the removal of nodules. An early intervention gives a better prognosis since most of the time, early intervention saves the patient from long-term impairment.

Symptoms of Vocal Cord Nodules?

The symptoms of vocal cord nodules can therefore vary with the severity of the situation; nonetheless, common signs are listed below:

Hoarseness: Usually the raspy or rough-sounding voice is the first noticeable symptom.
Vocal Difficulty: Fatigue of the voice occurs, after a period of talking or singing.
Reduced Vocal Range: Nodules make it difficult for a person to sing or speak their high and low pitches.
Scratchy Throat or Tightness: Some discomfort can be felt, or a sense of something stuck in the throat.
Lose a Voice: Rarely, the voice becomes extremely weak or in some cases is lost for a time.
Wheezing: There is a constant urge to clear the throat when there is some irritation in the vocal cords.
Breathy Voice: Some of them may also notice their voice sounding breathy, as the vocal cords do not come together properly.

Causes of Vocal Cord nodules?

The most common cause of vocal cord nodules is vocal abuse or vocal misuse, which causes irritation and swelling on the vocal cords. Other common causes include:

Vocal Overwork or misuse: Speaking or singing for a prolonged time in a loud voice, shouting, or excessive use of the voice in an improper way can cause strain on vocal cords. This is a prominent feature in occupations that require frequent speaking or singing, e.g., teachers, singers, or public speakers.
Excessive Clearings of Throat: Frequent clearing of throat can irritate the vocal cords, forming nodules.
Chronic Laryngitis: Infection or allergy-induced inflammation of the vocal cords can predispose the cords to an injury or swelling which eventually leads to nodes.
Poor Vocal Technique: Poor use of techniques while singing or speaking, such as straining the neck or throat, can put stress on the vocal cords.
Environmental Factors: The conditions of dry air, act of smoking, or any irritant exposure, whether dust or chemicals, can injure the vocal cords. These injuries increase the risk of nodules.
Acid Reflux (GERD): Due to gastroesophageal reflux disease, the acid from the stomach reaches the throat and irritates the vocal cords over the long term.

Diagnosis of Vocal Cord Nodules

Directing the diagnosis of vocal cord nodules typically requires a thorough examination by an ENT, often involving some specific diagnostic tools. The basic flow of the general process is described as follows:

Medical History and Symptoms Review: The doctor might ask the patient about the signs and symptoms of the disorder. Some of these may include hoarseness, voice fatigue, and discomfort in the throat. The doctor would then want to inquire about the vocal habits of the patient, such as yelling, singing, or prolonged speech. There would further be questions about throat infections or acid reflux in the past.
Physical Examination: The ENT specialist will employ a laryngoscope-a thin tube with a small camera-to visualize the vocal cords directly. This procedure is often done through the nose or mouth so that the specialist can get a good view of the vocal cords in action.
Stroboscopy: In certain instances, laryngeal stroboscopes will be used with laryngoscope examination. This enables the doctor to see a slow-motion video image of vocal cord movement on a display, which assists in visualizing minor abnormalities like nodules and in determining how freely the vocal cords are vibrating.
Voice Evaluation: A speech-language-pathologist (SLP) might perform some evaluations of the patient's voice quality, pitch, and range, thus helping to determine the level of impact on vocal function caused by the nodules.
Other Tests: The doctor may also suggest other tests to exclude different conditions, such as laryngitis, vocal cord paralysis, or even cancer, but are all uncommonly known to produce similar symptoms.

Treatment of Vocal Cord Nodules

Generally, therapeutic management depends on the severity of the condition and how much it is affecting the person's voice. In many cases, nonsurgical methods may be effective, especially if the nodules are detected early. The main treatment types include:

Voice Therapy: The first course of action usually entails consulting with a speech-language pathologist (SLP). Voice therapy concerns techniques intrinsic to phonation, which compresses and destroys the undue stress on the vocal cords. This may involve exercises to strengthen the voice and to aid closure of the vocal cords while decreasing unnecessary tension. This is one of the main effective therapies that helps prevent further damage and aids in the nodule healing process.
Voice Rest: Resting the vocal cords by refraining from talking, singing, or any activity that promotes vocal function can enable the nodules to heal. In more serious cases, absolute voice rest for a period will be required.
Hydration and Humidification: Keeping the vocal cords hydrated is critical for their recovery. Patients are encouraged to drink sufficient water and to use a humidifier, which will help soothe irritated vocal cords.
Avoiding Irritants: Limiting a person's exposure to smoke, dust, or any other environmental irritants is important, as such substances might cause more strain or damage to the vocal cords. Managing acid reflux (GERD), if it contributed to the condition, may further minimize this irritation, through lifestyle changes or medication.
Medication: Inflammation or acid reflux may prompt the doctor to prescribe some kind of medication, such as proton pump inhibitors (PPIs) for GERD or corticosteroids to decrease swelling.
Surgery: If the nodules persist with voice-disrupting symptoms despite therapy, surgical intervention may become necessary, albeit rarely. The nodules can be removed by a surgeon through a procedure called microlaryngoscopy, performed under general anesthesia. Usually, surgery will be considered when all other methods of treatment have failed.

Conclusion

Vocal cord nodules generally are not dangerous, but if they are ignored, they can do a lot of damage to a person's voice and the quality of life. Early detection and treatment, which include voice therapy, voice rest, and sometimes surgery, are vital to recovery.

Therefore, if you suspect that you might be having symptoms associated with vocal strain, it is always best to seek expert treatment immediately.

Tagore Hospital in Jaipur is one of the finest hospitals in Jaipur for those requiring specialist medical care, offering the highest quality of comprehensive treatment from ENT specialists with experience and advanced diagnostics. The hospital strives to give the best treatment available today, thus ensuring the best results for patients presenting with throat and voice-related conditions.