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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How to effectively treat vocal cord nodules?

Vocal cord nodules are a relatively common otolaryngological condition. In terms of treatment, it initially requires a laryngoscopic examination to assess the severity of the condition. Generally, conservative treatment is considered, commonly involving oral traditional Chinese medicine and nebulization therapy. Alongside medication, it's important to avoid excessive use of the voice and to engage in vocal rehabilitation training. Most patients will see gradual improvement in symptoms of hoarseness through these conservative treatments, and nodules may also gradually diminish in some cases. If standardized conservative treatments are ineffective and the symptoms of hoarseness are particularly severe, a small number of patients may consider surgical intervention.

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Written by Zhang Jun
Otolaryngology
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Will the voice change due to vocal cord nodules get better?

After surgery for vocal cord nodules, the voice will definitely improve and will not cause persistent hoarseness. Vocal cord nodules are vocal cord lesions caused by improper use of the voice over a long time, such as loud shouting or fatigue, and are commonly seen in teachers and singers. They can cause persistent hoarseness in patients and progressively worsen. Generally, vocal cord nodules occur bilaterally. Examination with an electronic laryngoscope reveals a symmetrical, pale white, smooth-surfaced neoplasm in the anterior-middle third of both vocal cords, with good vocal cord mobility and incomplete closure of the glottis. In terms of treatment, patients need to undergo vocal cord nodule removal surgery under supported laryngoscopy. The surgery requires hospitalization under general anesthesia, and patients can usually recover and be discharged a week after surgery.

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Written by Li Rui
Otolaryngology
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What should I pay attention to for vocal cord nodules usually?

Vocal cord nodules are a relatively common ENT (Ear, Nose, and Throat) disorder, and there are several aspects to be mindful of in daily life. The first aspect is to avoid excessive use of the voice. Frequent overuse can exacerbate symptoms of hoarseness and potentially worsen the condition of the vocal cord nodules. The second aspect concerns diet; it is advisable to eat lightly and avoid spicy and irritant foods. The third aspect pertains to lifestyle habits; do not smoke or drink alcohol. Both tobacco and alcohol are strong irritants to the mucous membranes and vocal cords, and they can potentially lead to a worsening of the vocal cord nodules.

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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 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.