Vocal nodules occur due to overtaxing and incorrect use of the voice.
Incidence and Aetiology of Vocal Nodules
● Age: Usually occur after puberty
● Sex: More common in females
What are the causes of Vocal Nodules?
● Vocal abuse.( Screaming, shouting, continuous loud talking, forceful throat clearing etc.This is seen in Seen in untrained singers, teachers, hawkers etc.
● Vocal misuse.This means talking in inappropriate pitch and loudness.
● Vocal nodules usually occur on both cords at the junction of anterior and middle one third.
● In children and adolescents, the misuse of voice leads to spindle-shaped thickening at the edges of the vocal cords.
● In adults, the swellings are more localized forming vocal nodules.
● The epithelium over the edges of the vocal cords undergoes hyperkeratosis resulting in a disturbed mucosal wave.
● Microscopically, there is submucous transudation followed by ingrowth of vessels and fibrous organization.
What are the clinical features of vocal nodules?
● Hoarseness of voice as the nodules interfere with vibrations of vocal cord
● Vocal fatigue
● Inability to sing too high or low tones
● Indirect laryngoscopy reveals symmetrical small nodules
● Voice rest and Vocal hygiene
● Voice therapy
● Steam inhalation helps to reduce edema around vocal cords in cases of laryngitis
This is the treatment of choice for well-formed vocal nodules
● Excision by Microlaryngoscopy
● Excision by Laser Microlaryngoscopy