Early symptoms of vocal cord nodules

Written by Yao Jun
Otolaryngology - Head and Neck Surgery
Updated on September 16, 2024
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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.

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Written by Li Rui
Otolaryngology
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Is the surgery for vocal cord nodules uncomfortable?

Surgery for vocal cord nodules is not particularly uncomfortable, and as of now, it is not the first-choice treatment option. In fact, most patients can consider conservative treatment. This generally involves oral medications and nebulization therapy, and voice rehabilitation training can also be considered. Most patients can effectively control and alleviate their condition after standardized conservative treatment. If the effects of standardized conservative treatment are not satisfactory, surgery may be considered. The current surgical options include microlaryngoscopic surgery or vocal cord nodule excision under fiberoptic laryngoscopy, both of which are minimally invasive and cause minor damage. General anesthesia can also be considered; during the surgery, patients do not feel particularly uncomfortable. After the surgery, it mainly requires voice rest and continuing with nebulization therapy.

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Written by Li Mao Cai
Otolaryngology
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Will there be a change in voice after vocal cord nodule surgery?

Vocal cord nodules commonly develop symmetrically at the anterior-middle third of both vocal cords. After the surgery for this condition, the hoarseness in the voice might initially worsen compared to before the surgery, particularly during the recovery period. After the surgery, it's crucial to rest the voice, meaning speaking less. Voice rest also includes proper phonation, which entails speaking correctly or not at all. It is advised to limit speaking to no more than five sentences per day. Moreover, during recovery, the voice may initially sound more hoarse than before the surgery but it should return to a state similar to that before the surgery once fully recovered. If after the surgery and subsequent recovery, the voice does not vary significantly from its pre-surgery state, this is generally the expected outcome. However, it isn't guaranteed 100%, as variations can occur depending on whether adequate voice rest was taken and whether proper phonation techniques were employed post-surgery.

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Written by Zhang Jun
Otolaryngology
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Scraping therapy is effective for vocal cord nodules

Vocal cord nodules are ineffective with scraping therapy. Vocal cord nodules are bilateral vocal fold lesions caused by improper voice use over long periods, excessive strain, loud yelling, or irritation from gastric acid reflux. They can cause persistent hoarseness in the patient, progressively worsening over time. If a patient experiences long-term hoarseness without improvement, it is essential to undergo an examination with an electronic laryngoscope at a hospital. This can reveal a symmetrical, smooth-surfaced, protein-based abnormal growth at the anterior-middle third of both vocal cords, leading to incomplete closure of the vocal folds, which results in hoarseness. Treatment requires surgical intervention, as scraping therapy is ineffective. The procedure involves the removal of the vocal cord nodules under general anesthesia with a surgical laryngoscope. Post-surgery, antibiotics are used to prevent local infection and recovery is typically within about a week for hospital discharge.

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Written by Yao Jun
Otolaryngology - Head and Neck Surgery
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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.

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Written by Li Mao Cai
Otolaryngology
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Vocal cord nodules are caused by what?

Vocal cord nodules are mainly caused by improper speaking, excessive speaking, emotional excitement, and shouting. The most common symptom of vocal cord nodules is a hoarse voice. This condition is often seen in people who speak a lot, such as teachers, salespeople, and singers. These include individuals who tend to shout, are impatient, and speak improperly. Such cases are commonly seen in clinics, especially among children. For example, children who shout and speak carelessly at school during the semester may develop vocal cord nodules with hoarseness as a symptom. Additionally, emotionally excitable and impatient people can develop nodules. Some grandparents, who often yell at their children at home, also tend to develop vocal cord nodules. In summary, those who speak too much, shout, mispronounce sounds, or are emotionally excitable are at risk of developing vocal cord nodules.