Nodules are bilateral epithelial (on the membranous surface located) thickenings. They may be compared with callus on the hands, and are caused by mechanical voice overuse. The origin is mostly misuse of the voice or inadequate, false voice technique.
Because of the additional mass and stiffness, nodules can cause vibratory disturbances and therefore lead to significant hoarseness. If changes of voice technique cannot resolve the nodules, we recommend phonomicrosurgical removal with high precision instruments. In most cases after adequate microsurgery and voice therapy, nodules will not recur again.