The Causes, Symptoms, and Treatment of Vocal Nodules

Vocal folds, popularly known as vocal cords, are the tissues in the larynx (voice box) that regulate airflow to the lungs and produce sounds through vibration. Our vocal cords may develop lesions that cause scratchy voice, hoarseness, and breathiness. What are the symptoms of vocal nodules, and how can we treat them?

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Vocal cord nodules, defined

Vocal cord nodules are one type of vocal cord lesions, which are non-cancerous growths similar to the callouses that develop in your hands. The other types of vocal cord lesions are polyps and cysts. Here are their differences:

• Nodules appear in pairs in both vocal cords. The nodes have some blood vessels, and they commonly occur in women ages 20 to 50, but can also affect men.
• Polyps are larger and more vascular, which means they have more blood vessels. Additionally, they resemble blisters and can develop in one or both vocal cords.
• Cysts are fluid-filled sacs that usually appear on one vocal cord. They are less common than nodules and polyps.

Causes of vocal nodules

The symptoms of vocal nodules usually occur due to repetitive phonotrauma or vocal cord abuse, which can happen when we:

• Improperly use our voice, such as when we sing or speak loudly or at an abnormally high or low pitch.
• Abuse or cause strain and injury to our vocal cords by talking excessively, screaming, smoking, and/or coughing harshly.
• Overuse our vocal cords by talking or singing for long periods without taking a break.

Vocal polyps and cysts can also occur due to repetitive phonotrauma. But polyps can likewise happen after just one episode, while cysts can develop if the vocal cord glands that secrete mucous become clogged.

Aside from trauma, an underlying medical condition can also contribute to the formation of vocal nodes. For instance, gastroesophageal reflux disease (GERD) can worsen the symptoms of vocal nodules by causing additional inflammation. Respiratory conditions that result in chronic cough can also cause vocal cord lesions.

Symptoms of vocal nodules

A person with vocal cord nodules may experience the following symptoms:

• A raspy or scratchy voice
• Breathiness
• Hoarseness
• Shooting pain from ear to ear
• A feeling that there’s a lump in your throat
• Reduced ability to change your pitch
• Neck pain
• Body and voice tiredness

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Vocal nodules treatment

Treating the symptoms of vocal nodules depends on the cause, the nodes’ size, and the severity of the symptoms you experience.  Your doctor may recommend the following options:

Speech therapy

With speech therapy, a speech pathologist will guide you on helpful strategies for more efficient voice use. The strategies will help you find the ideal voice pitch and volume for healthier speaking. You’ll also learn about exercises that improve breathing and reduce strain.  Overall, speech therapy helps heal vocal cord injury and prevent future trauma.

Microsurgery

People with relatively large nodules, polyps, or cysts may undergo microsurgery, especially if they have the lesions for a long time. In this procedure, the surgeon will insert tiny instruments into the throat to remove the nodes. In most cases, you need to undergo speech therapy after undergoing microsurgery.

Laser surgery

The removal of lesions through laser surgery is also an option. During this procedure, you may be awake or under general anesthesia. The surgeon will insert a scope into your nose and throat and direct laser beams into the nodes to shrink them. Please note that you may need second laser surgery to remove the lesion entirely. The doctor will most likely recommend speech therapy after the surgery.

Medical management

Finally, to treat vocal nodes, the doctor will order voice rest and, perhaps, medications like steroids to reduce the swelling or inflammation. Additionally, if an underlying habit or medical condition contributes to the symptoms of vocal nodules, the doctor will work with you to manage it.

Learn more about Throat Conditions here.