Vocal cord nodules are bilaterally symmetrical benign white masses that form at the midpoint of the vocal folds.[1] Although diagnosis involves a physical examination of the head and neck, as well as perceptual voice measures, visualization of the vocal nodules via laryngeal endoscopy remains the primary diagnostic method.[2][3] Vocal fold nodules interfere with the vibratory characteristics of the vocal folds by increasing the mass of the vocal folds and changing the configuration of the vocal fold closure pattern.[1][2][4] Due to these changes, the quality of the voice may be affected.[1] As such, the major perceptual signs of vocal fold nodules include vocal hoarseness and breathiness.[4][5] Other common symptoms include vocal fatigue, soreness or pain lateral to the larynx, and reduced frequency and intensity range.[1][4][5] Airflow levels during speech may also be increased.[1] Vocal fold nodules are thought to be the result of vocal fold tissue trauma caused by excessive mechanical stress, including repeated or chronic vocal overuse, abuse, or misuse.[1][2][5] Predisposing factors include profession, gender, dehydration, respiratory infection, and other inflammatory factors.[1][2]
For professional voice users as well as individuals who frequently experience hoarseness, vocal hygiene practices are recommended for the prevention of vocal fold nodules and other voice disorders.[6] Vocal hygiene practices include three components: regulating the quantity and quality of voice use, improving vocal fold hydration, and reducing behaviours that jeopardize vocal health.[6] About 10% of nodules resolve on their own, which is more likely if they are smaller and the onset more recent.[7] Treatment of vocal fold nodules usually involves behavioural intervention therapy administered by a speech–language pathologist. In severe cases, surgery to remove the lesions is recommended for best prognosis.[8][9] In children, vocal fold nodules are more common in males; in adults, they are more common in females.[10][5]
^ abcdJohns, Michael M. (2003). "Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts". Current Opinion in Otolaryngology & Head and Neck Surgery. 11 (6): 456–61. doi:10.1097/00020840-200312000-00009. PMID14631179. S2CID45661781.
^ abcColton, Raymond H.; Casper, Janina K.; Leonard, Rebecca (2006). "Nodules". Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment. Lippincott Williams & Wilkins. pp. 100–4. ISBN978-0-7817-4239-9.
^ abcdKunduk, Melda; McWhorter, Andrew J (2009). "True vocal fold nodules: the role of differential diagnosis". Current Opinion in Otolaryngology & Head and Neck Surgery. 17 (6): 449–52. doi:10.1097/MOO.0b013e3283328b6d. PMID19779347. S2CID8834120.
^Nakagawa, Hideki; Miyamoto, Makoto; Kusuyama, Toshiyuki; Mori, Yuko; Fukuda, Hiroyuki (2012). "Resolution of Vocal Fold Polyps With Conservative Treatment". Journal of Voice. 26 (3): e107–10. doi:10.1016/j.jvoice.2011.07.005. PMID22082864.
^Dobres, Rachel; Lee, Linda; Stemple, Joseph C.; Kummer, Ann W.; Kretschmer, Laura W. (1990). "Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists". Journal of Speech and Hearing Disorders. 55 (3): 526–32. doi:10.1044/jshd.5503.526. PMID2199731.