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.
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