What are Vocal Fold Nodules?
Vocal fold nodules are tiny bumps, like a callus, which occur on the edges of the vocal folds as a result of excessive friction. Over time they develop from a slight reddening to a swelling, then into nodules. They usually form as a pair, one on each fold opposite each other, around the anterior third of the fold.
Why are they problematic to voice?
Vocal nodules prevent the vocal folds coming together when you talk. This affects the quality of the voice. They may cause the vocal folds to become stiff preventing them from vibrating properly. Larger nodules may mean the muscles of the voice box (larynx) have to work harder which may mean your voice will tire more easily.
What are the symptoms?
Voice change is dependent on size and type of nodule.
· Hoarseness; lowered-pitch; breathy, rough quality; effortful voice with breaks.
· Throat discomfort.
· Throat-clearing.
· Voice worsens with use.
What causes nodules?
A combination of some of the following factors can contribute to vocal fold nodules:
· Continued use of voice with increased pitch or volume.
· Shouting/ screaming.
· Talking over background noise.
· Singing.
· Excessive coughing/ throat-clearing.
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· Insufficient water, smoking and reflux.
What can be done?
Voice therapy is the preferred choice of treatment to help reduce symptoms and improve voice quality.
Alter the way you use your voice:
· Avoid excessive voice use.
· Try not to compete with background noise.
· Rest your voice whenever possible.
· Avoid forcing the voice.
· Minimise throat-clearing and coughing.
Adopt good vocal hygiene:
· Drink plenty of fluids. Approximately 2 litres per day.
· Limit alcoholic and fizzy drinks.
· Avoid dry, dusty, smoky atmospheres which can irritate the vocal folds.
· See your GP if you are experiencing acid reflux.
In some cases surgical intervention by ENT is indicated.