THROAT – Vocal Nodules

Introduction to vocal nodules:

Vocal nodules occur due to overtaxing and incorrect use of the voice.

Incidence and Aetiology of Vocal Nodules

●  Age: Usually occur after puberty

●   Sex: More common in females

What are the causes of Vocal Nodules?

●   Vocal abuse.( Screaming, shouting, continuous loud talking, forceful throat clearing etc.This is seen in Seen in untrained singers, teachers, hawkers etc.

●   Vocal misuse.This means talking in inappropriate pitch and loudness.

Pathology of Vocal Nodules.

●   Vocal nodules usually occur on both cords at the junction of anterior and middle one third.

●   In children and adolescents, the misuse of voice leads to spindle-shaped thickening at the edges of the vocal cords.

●   In adults, the swellings are more localized forming vocal nodules.

●   The epithelium over the edges of the vocal cords undergoes hyperkeratosis resulting in a disturbed mucosal wave.

●   Microscopically, there is submucous transudation followed by ingrowth of vessels and fibrous organization.

What are the clinical features of vocal nodules?

●  Hoarseness of voice as the nodules interfere with vibrations of vocal cord

●   Vocal fatigue

●   Inability to sing too high or low tones

●   Indirect laryngoscopy reveals symmetrical small nodules

What is the treatment of vocal nodules?
Medical treatment:

●  Voice rest and Vocal hygiene

●  Voice therapy

●   Steam inhalation helps to reduce edema around vocal cords in cases of laryngitis

Surgical treatment:

This is the treatment of choice for well-formed vocal nodules

●   Excision by Microlaryngoscopy

●   Excision by Laser Microlaryngoscopy