Information From Your Health Care Provider

VOCAL CORD NODULES

(Singer's Nodes)

Basic information

description

Vocal cord nodules are benign (noncancerous) over-growths of tissue on the vocal cords. The condition can be common in children and occurs in women more than men.

FREQUENT SIGNS & SYMPTOMS

Persistent hoarseness without pain.
Breathy or scratchy voice.
Singers may notice they have a voice alteration.

causes

The vocal cords are located in the voice box (larynx) in the middle of the throat. They are made up of two fibrous bands that vibrate to produce sound. The bands are covered with skin-like tissue. This tissue becomes thickened when the vocal cords are used a lot. A part of the thickened tissue can grow and produce nodules. They appear as red, swollen bumps and may be the size of a pinhead up to a small pea. When nodules occur, the vocal cords cannot close completely. This causes the voice to sound hoarse.

risk increases with

Continued overuse of the voice by singing, shouting, yelling, lecturing, or other forms of talking too loudly or too much.
Excessive coughing or throat clearing.
Using the voice incorrectly.
People who use the voice a lot such as singers, teachers, ministers, auctioneers, cheerleaders, aerobic instructors, and others.
Smoking or exposure to smoke.
Chronic infection caused by allergies or irritants.
Reflux (stomach acid backs up into throat).

PREVENTIVE MEASURES

Take voice or speech lessons to learn proper techniques for speaking or singing.
Don't smoke. Avoid being around smokers.
Drink plenty of fluids.
Try not to use the voice too long or too loudly.
Rest your voice for a while when it appears to have been overused.

expected outcomes

Almost always curable with voice therapy treatment or surgery.

possible complications

Without treatment, permanent hoarseness or voice change may occur.
Nodules may regrow after treatment if voice continues to be overused.

diagnosis & treatment

general measures

Your health care provider will do a physical exam of the throat and vocal cords and ask questions about your symptoms and how you use your voice. A laryngoscope (a small, narrow tube with a light) is often used to view the throat and vocal cords. It may be inserted through the nose or the mouth.
Any underlying disorder, such as reflux, will be treated as needed.
Treatment usually involves voice therapy (voice behavior). This may include voice rest (using your voice less, controlling the loudness, and not talking much for a few days). Don't whisper (it can irritate the vocal cords). Write notes to communicate.
Voice therapy can include behavior training on healthy use of the voice and proper voice techniques. Therapy may take 1 to 2 sessions a week for 5 to 6 weeks.
Surgery (rarely) to remove nodules may be needed if voice therapy is not effective. Surgery is usually not done in children under age 12.
Quit smoking. Find a way to stop that works for you.

medications

Drugs are usually not needed for this disorder.

activity

No limits except those for voice usage.

diet

No special diet. Drink plenty of fluids each day.

notify our office if

You or a family member has symptoms of vocal cord nodules.
Symptoms don't improve with treatment.