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Vocal Fold Nodules

What are vocal fold nodules?

Vocal fold nodules are benign (non-cancerous) lesions, typically found bilaterally (on both sides). Vocal fold nodules are most often the result of voice abuse, misuse, or overuse over an extended period of time. The repeated impact on the surface of the vocal folds often results in callous like lesions. Nodules can vary in size greatly, from pin-size to quite large.

What are the symptoms of vocal fold nodules?

The effect nodules have on the voice varies depending on the size of the lesions and how long they have been there for. Nodules typically cause some degree of hoarseness and may cause vocal fatigue (tiredness) or a feeling of vocal strain. In singers, nodules often cause a loss of high range and/or a husky/heavy quality to the voice.

How are vocal fold nodules treated?

The first line of treatment for nodules is always voice therapy. Nodules can often be remediated with voice therapy, which not only avoids surgery but also teaches better voice habits in order to avoid the recurrence of nodules. If surgery is performed without initially attempting voice therapy, nodules often quickly recur due to poor voice usage and phonotraumatic voice habits (i.e misuse and abuse of the voice). For a patient who has been fully compliant, has worked with a skilled voiced therapist, and the nodules persist, surgery may be warranted.