What Are Vocal Cord Nodules (Singer’s Nodules)?

Vocal cord nodules are painless “lumps” that develop on the vocal cords and cause a slowly progressive voice change (hoarseness). Vocal cord nodules are noncancerous and almost always develop due to improper or excessive voice use. Over time, repeated abuse of the vocal cords results in soft swellings on each vocal cord. If abuse will continue, these swellings will develop into harder, callous-like “lumps”.

Vocal nodules are more common in people that overuse their voice, like teachers, singers, TV and radio reporters etc. Moreover, vocal cord nodules can also develop due to different abusive vocal behaviors like chronic throat clearing, chronic coughing, yelling and whispering. As they frequently occur in untrained singers, the other common name for vocal nodules is "singer's nodules."

 Small, callus-like "lumps" on both vocal cords ("singer's nodules")

Healthy vocal cords completely come together to create a voice. In a patient with vocal cord nodules, vocal cords cannot completely adhere, as there is a bulge in the center of the vocal cords resulting in an hourglass gap when they come together. Unless the underlying voice abuse is reversed, the nodule will just get bigger with corresponding deterioration of a voice quality. Initially, the voice change may only occur in the high pitches. However, as these “lumps” get bigger, the hoarseness may extend to throughout the entire vocal pitch range.

If there is a suspicion that you might have vocal cord nodules, your ENT specialist will perform an examination that is called laryngoscopy. A small angled mirror, a rigid endoscope or flexible endoscope are utilized to deflect a beam of light down onto the vocal folds and reflect the image of the vocal cords back up to the ENT specialist.

The voice therapy and avoidance of any activities leading to voice abuse (screaming, yelling, etc.) are the mainstays of conservative management of vocal cord nodules. However, such treatment can take months. Alternative for conservative therapy may be the surgical micro-excision of the vocal nodule, a procedure in which the vocal nodule is excised with tiny blades under the control of the high-magnification microscope. Additionally, several recent studies have shown that vocal quality improvement may be obtained by steroid injections into the vocal cord nodule.

http://twitter.com/DrSasaJanjanin

Dr. Sasa Janjanin is double European Board-certified in ENT and Facial Plastic Surgery. He extensively trained in complete surgical and medical treatment of patients with disorders and diseases of the head and neck. However, his major expertise is in facial plastic, aesthetic and reconstructive surgery; problems related to thyroid and parathyroid glands; skin cancer; kid’s ENT problems; minimally-invasive voice-box surgery; nose, sinus and snoring complaints; and sport and diving-related ENT problems.