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Vocal cord nodules
How to treat vocal cord nodules
Vocal cord nodules, also known as singer's nodules, are typically located at the junction of the anterior and middle thirds of both vocal cords, featuring symmetrical nodular protrusions. They are more commonly found in individuals who use their voices professionally, such as singers, teachers, or other vocations that involve frequent shouting, as well as in children. Prolonged or improper use of the voice is a major cause of this condition. Therefore, during treatment, voice rest is primarily advised. Early stage vocal cord nodules can spontaneously resolve with sufficient vocal rest, and nodules in children often disappear naturally during puberty. Additionally, medication can be used for treatment, such as traditional Chinese medicines, including Jin Sang San Jie Wan and Kai Yin Pills. If conservative treatment fails, surgical removal of the vocal cord nodules under fiberoptic laryngoscopy can be performed, followed by a two-week voice rest period. Post-surgery, it is recommended to inhale medicated vapors, avoid spicy and irritating foods, drink plenty of water, avoid staying up late, and refrain from excessive voice use or shouting.
Do vocal cord nodules hurt?
Vocal cord nodules are symmetric, benign protrusions that occur on the free edge of the vocal cords. Clinically, the main symptoms of vocal cord nodules include a hoarse voice and fatigue after prolonged speaking, typically without any sensation of pain or causing any pain. Treatment primarily involves medication, voice therapy, and for some vocal cord nodules that appear after an acute upper respiratory infection, hormonal treatment may be required, or combined with some antibiotics. In summary, vocal cord nodules do not cause painful symptoms, and treatment focuses mainly on voice training and rest for the vocal cords.
How to treat vocal cord nodules?
The main symptom of vocal cord nodules is a hoarse voice, and some people often experience coughing. The cause of vocal cord nodules is related to excessive talking or improper use of the voice, such as in occupations like teachers, salespeople, and singers. Besides voice therapy, another treatment option is nebulizer inhalation, which is used to alleviate symptoms. Commonly used medications include corticosteroids, such as budesonide for nebulizer inhalation treatment, twice a day, one dose each time, but voice therapy is a prerequisite. Without voice therapy and correct voice usage, treatment with medication alone through nebulizer inhalation will not be effective, and the symptoms will not improve significantly. Some patients with vocal cord nodules do not need medication and can fully recover their normal voice and have the nodules disappear just by proper voice therapy and resting the voice for a period. Therefore, voice therapy is the best treatment for this condition.
Which is more serious, vocal cord nodules or vocal cord polyps?
Vocal cord nodules and vocal cord polyps are both benign occupies of the vocal cord area. Vocal cord nodules appear as point-like and nodular protrusions, while vocal cord polyps appear as polyp-like protrusions, and thus, the volume of vocal cord polyps is relatively larger. Generally speaking, the hoarseness associated with vocal cord nodules is milder, while the hoarseness from vocal cord polyps is more severe. In terms of treatment, vocal cord nodules generally do not require surgical intervention and are mainly managed with voice rest and symptomatic treatment. On the other hand, vocal cord polyps almost always require surgical treatment for resolution. Therefore, overall, vocal cord polyps are more severe, while vocal cord nodules are relatively milder.
How long does it usually take for vocal cord nodules to heal?
Vocal cord nodules are primarily caused by improper pronunciation or overuse of the voice, commonly seen in people who use their voices frequently. Treatment primarily involves vocal rest, which means speaking less and pronouncing correctly. The period of vocal rest usually needs to be relatively long. If the vocal cord nodules are larger, then an even longer period of vocal rest may be required, generally lasting from two to four weeks. Clinically, most cases require four weeks. The effects are generally better after resting for four weeks. During this period, treatment can be complemented with medications, such as nebulized inhalation, which can speed up recovery. The premise is to first undergo vocal rest followed by medication treatment, which generally takes about two to four weeks.
Early symptoms of vocal cord nodules
Vocal cord nodules, also known as singer's nodules, typically present as symmetrical nodular protrusions at the junction of the anterior and middle one-thirds of the vocal cords, with a relatively broad base. The main symptom is hoarseness of voice. Initially, the hoarseness is mild, characterized by a rough voice or nearly normal voice, such as when the voice is overused and feels fatigued, leading to intermittent bouts of hoarseness. Over time, the symptom of hoarseness worsens, progressing from intermittent to persistent hoarseness, affecting singers who cannot sing and teachers who are unable to teach. Examination with a laryngoscope may reveal small nodular protrusions on the anterior-middle one-third of the vocal cords, with incomplete closure of the glottis.
Treatment methods for vocal cord nodules
The treatment is primarily divided into conservative treatment and surgical treatment. Generally, conservative treatment is implemented first. The main strategy of conservative treatment is vocal rest, which entails speaking as little as possible, typically for a duration of two to four weeks. Concurrently, medication is administered, often through nebulized inhalation therapy. The second approach is surgical treatment, which is considered if the conservative treatment does not yield satisfactory results, or if the condition worsens. At this point, surgical treatment of vocal cord nodules is typically performed using support laryngoscopy, microscopy, and either laser or fiber instruments to remove the vocal cord nodules. Post-surgery, a period of vocal rest is necessary for recovery, also lasting two to four weeks. During the recovery period, it is important to speak less, use proper phonation, avoid smoking and alcohol, follow a light diet, and steer clear of spicy and irritating foods.
Are vocal cord nodules prone to recurrence?
Vocal cord nodules are symmetrical nodular protuberances on the free edges of both vocal cords. Clinically, vocal cord nodules are mainly related to improper use of the voice and are prone to recurrence. Recurrence factors primarily involve inappropriate voice use, voice abuse, and other irritants such as tobacco, alcohol, chili peppers, and other spicy foods, as well as frequent recurring upper respiratory infections. Therefore, clinically, in addition to medication, such as drugs that clear the throat and benefit the voice, attention should also be paid to diet structure and normal voice use to avoid excessive voice abuse.
Is surgery necessary for vocal cord nodules?
Vocal cord nodules are benign lesions on the vocal cords, primarily characterized by bilateral symmetrical protrusions on the free edge of the vocal cords. These protrusions are small and nodular. The majority of vocal cord nodules do not require surgical intervention and are mainly treated with medication. For those vocal cord nodules that do not improve with medication or voice correction, they may gradually progress to vocal cord polyps or other lesions. Only after an assessment deems surgery appropriate, is surgery considered. Overall, vocal cord nodules do not require surgical treatment.
Can vocal cord nodules heal by themselves?
Vocal cord nodules, also known as singer's nodules, typically involve symmetrical nodular protrusions at the junction of the anterior and middle thirds of both vocal cords. This condition is commonly seen in individuals who use their voices professionally or excessively, such as actors, teachers, individuals in vocations that require shouting, and children. The primary cause of this condition is attributed to long-term excessive or improper use of the voice. Early stage vocal cord nodules can disappear by allowing the vocal cords to rest sufficiently through voice rest; in children, vocal cord nodules might disappear after puberty. If these nodules do not resolve with conservative treatment and voice rest, medical treatment or surgery may be necessary.