Vocal fold nodules

Nodules are bilateral epithelial (on the membranous surface located) thickenings. They may be compared with the callus on the hands and are caused by mechanical voice overuse. The origin is often misusing the voice or inadequate, false voice technique.

Vocal cord nodules are initially soft and little audible, later increasing (fibrosing) and becoming harder. Along with this, the voice becomes more auditorily conspicuous.
Vocal cord nodules occur most frequently in children (so-called “crying nodules”) and often regress on their own after puberty. Vocal cord nodules are also often found in young women with increased vocal stress.

Because of the additional mass and stiffness, nodules can cause vibratory disturbances and therefore lead to significant hoarseness. If changes in voice technique cannot resolve the nodules, we recommend phonomicrosurgical removal with high-precision instruments. In most cases, after an adequate microsurgery and voice therapy, nodules will not recur again.

Symtoms: Hoarseness, compulsive throat clearing, missing notes, voice slumping away, vocal clenching.
Vocal fold nodles

The primary treatment recommended for vocal fold nodules is voice therapy to improve vocal technique. However, in some cases, when a clear and resilient voice is desired, this is not sufficient and the vocal cord nodules must be ablated. This can be done under general anesthesia or transorally with local anesthesia. Voice surgery (phonosurgery) for nodules on the vocal cords is quite advisable in children with a high level of distress. Continuation of voice exercise therapy after surgery is usually recommended to prevent recurrence of the change (so-called sandwich method: voice therapy – surgery – voice therapy).
Conclusion: Although vocal cord nodules tend to be a chronic voice disorder, clinically this can more or less suddenly turn into a disturbing dysphonia. Conservative therapy is usually sufficient; surgery may be required. Especially for singers, but also for all others, we offer post-operative voice rebuilding therapy.