Vocal Cord Nodules
Vocal cord nodules (also known as vocal nodes or singer’s nodes) are a frequent cause of hoarseness, particularly in people who use their voice a lot. They are a little bit like “calluses” on the vocal cords, and form as a result of repetitive banging of the vocal cords against each other when the voice is used excessively or too harshly. This causes the delicate outer layer of the vocal cords to get swollen, causing little bumps (nodules) on the surface of the vocal cords and making it difficult for the vocal cords to make full, smooth contact.
The most common symptom of vocal cord nodules is hoarseness. The voice often has a breathy, rough, or strained quality. Some people may notice that their voice tires out more easily or they run out of air when talking, or that their voice quality gets worse the more they use their voice. Singers may notice trouble sustaining notes, or loss of the upper vocal register.
Vocal cord nodules are most commonly seen in people who use their voice throughout the day, such as teachers, singers, fitness instructors, and coaches.
Vocal cord nodules are best diagnosed by examination of the vocal cords with high resolution videostroboscopy (a “strobe” exam) by a fellowship-trained laryngologist.
In the majority cases, vocal cord nodules can be effectively treated by a combination of temporarily reducing voice use and working with a qualified voice therapist (speech language pathologist) to improve vocal technique and eliminate harmful vocal behaviors. Addressing other factors that can irritate the vocal cords (such as acid reflux, allergies, and coughing) is also an important part of effective treatment. In the few cases that don’t respond to these initial treatment steps, procedures such as vocal cord steroid injections or surgical removal of the nodules may be required, but it should be noted that MOST cases resolve without needing to have a procedure done.
Videostroboscopy exam showing vocal cord nodules