What are vocal cords?
Vocal cords (also known as vocal folds) are composed of twin infolding of mucous membrane stretched horizontally across the larynx. They vibrate, modulating the flow of air being expelled from the lungs during phonation. Vocal cords are open during breathing. They are closed during speech or singing.
What are vocal cord nodules?
Vocal cord nodules are small bumps (like a small callus) which develop on the vocal cords. Over time, they develop from a slight reddening, to a swelling and then to definable nodules. They occur on both cords and are symmetrical. Nodules are a problem because they may create a gap between the vocal cords, allowing air escape and preventing normal vibration.
What causes nodules?
Nodules develop in response to excessive friction between the cords. As a result, nodules typically occur in children and adults who use their voice intensely across an extended period of time. Shouting, screaming, singing, excessive coughing and throat clearing and poor vocal care (i.e. smoking, insufficient water intake) can contribute to the development of nodules. Nodules are a natural response to increased trauma (similar to calluses on your hands).
What are the symptoms?
The symptoms of vocal cord nodules vary depending on the type and size of the nodules. Generally, the onset of symptoms is gradual, with short episodes of symptoms experienced, and then eventually consistent (i.e. symptoms experienced all the time).
Symptoms may include:
- Onset of hoarse voice quality
- Breathy or rough voice quality
- Increased effort to produce voice
- Occasional voice/pitch breaks
- Vocal fatigue (voice deteriorates with use)
- Throat discomfort and throat clearing
What treatments are available?
An Ear Nose and Throat doctor will diagnose the presence of vocal cord nodules. Voice therapy is the preferred management option for the treatment of vocal cord nodules. A speech language pathologist is able to advise an appropriate management plan. This may include reduction of vocal irritants, adjustments to vocal behaviours and regular voice therapy. In some cases, surgical intervention may be required to improve voice quality.
