Vocal cord nodule

Vocal voice nodule
Other namesVocal fold nodules, Vocal nodules
SpecialtyOtorhinolaryngology Edit this on Wikidata

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]

  1. ^ a b c d e f g Verdolini, Katherine; Rosen, Clark A.; Branski, Ryan C., eds. (2014). "Vocal Fold Nodules (Nodes, Singer's Nodes, Screamer's Nodes". Classification Manual for Voice Disorders-I. Psychology Press. pp. 37–40. ISBN 978-1-135-60020-4.
  2. ^ a b c d Johns, 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. PMID 14631179. S2CID 45661781.
  3. ^ Pedersen, Mette; McGlashan, Julian; Pedersen, Mette (2012). "Surgical versus non-surgical interventions for vocal cord nodules". The Cochrane Database of Systematic Reviews. 2012 (6): CD001934. doi:10.1002/14651858.CD001934.pub2. PMC 7064879. PMID 22696326.
  4. ^ a b c Colton, 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. ISBN 978-0-7817-4239-9.
  5. ^ a b c d Kunduk, 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. PMID 19779347. S2CID 8834120.
  6. ^ a b Leonard, Rebecca (2009). "Voice therapy and vocal nodules in adults". Current Opinion in Otolaryngology & Head and Neck Surgery. 17 (6): 453–7. doi:10.1097/MOO.0b013e3283317fd2. PMID 19741535. S2CID 42269683.
  7. ^ Simpson, Blake; Rosen, Clark (2008). "Vocal Fold Nodules". Operative Techniques in Laryngology. Springer. pp. 105–7. doi:10.1007/978-3-540-68107-6_16. ISBN 978-3-540-25806-3. S2CID 234161002.
  8. ^ Béquignon, Emilie; Bach, Christine; Fugain, Claude; Guilleré, Lia; Blumen, Marc; Chabolle, Frédéric; Wagner, Isabelle (2013). "Long-term results of surgical treatment of vocal fold nodules". The Laryngoscope. 123 (8): 1926–30. doi:10.1002/lary.23768. PMID 23757348. S2CID 36758075.
  9. ^ 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. PMID 22082864.
  10. ^ 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. PMID 2199731.