Vocal Nodules

Aetiology

  • Vocal fold nodules are caused by vocal trauma (particularly phonotrauma) e.g. excessive singing/shouting/screaming or even talking

Presentation

  • A change in voice- usually hoarseness
  • painful speech (dysphonia)
  • If the patient is a singer, they may report a rduced range and complain of vocal breaks too

Investigation

  • Laryngoscopy
    • Nodules will be seen at the junction of the anterior 1/3 and posterior 2/3 of the cords (middle of the membranous vocal folds

Management

  • If they are caught early/symptoms are not too severe- speech therapy and education may be all that’s indicated.
  • If they are large/very symptomatic- surgical removal can be done (NB if the patient is a professional singer, warning about the potential risks of surgery- e.g. reduced range/sustainability- should be discussed)
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