Nodules

Vocal nodules are symmetric swellings of the vocal folds occurring in a predictable pattern. They are usually the results of phonotrauma. Nodules are a well-known problem in amateur and professional singers, teachers, cheerleaders, and does who uses her voice extensively professionally. Vocal fold nodules exist along a continuum of very early swelling from excessive voice stress to firm calluses from chronic misuse. Vocal nodules may be treated with voice rest which usually results in decreasing the swelling associated with their formation. Often this is not enough to resolve them however. Voice therapy is the primary treatment modality utilized. The vast majority of nodules can be managed with voice therapy. It is important to understand that vocal fold nodules are associated with voice use patterns and perhaps factors beyond our control like microscopic anatomical differences. Sometimes this can be a frustrating process. Occasionally, microlaryngeal surgery is considered in the management of nodules. This is particularly true when the nodules have become firm and scar has become associated with them. Nevertheless, and almost all cases voice therapy is considered the starting point.