JANUARY 25TH, 2023

Vocal cord nodules are non-cancerous growths/bumps on the vocal cords that form due to frequent abuse of the voice over time, e.g., screaming, singing. 

• Presenting Symptoms: Raspy or hoarse voice.

• Epidemiology: Commonly found in young women and adolescent boys. Also, a common problem amongst professional singers. 

• Etiology/Pathophysiology: Caused by overuse or abuse of the vocal cords, e.g., screaming, singing, crying. Traumatic vibration-induced dilation of the superior vocal fold vessels creates inflammatory tissue and focal reaction. The resultant nodules are bilateral, symmetric broad-based lumps usually around the midpoint (point of highest amplitude) of the vocal cord. Note: unilaterality likely indicates a polyp or other lesion.  

• Diagnosis: Direct visualization of vocal cords via flexible nasolaryngoscopy, mirror laryngoscopy, or  stroboscopy (to measure vocal cord movement). Vocal cords may also be erythematous or edematous in early stages and fibrotic and white in later stages.

• Treatment: Conservative management with voice therapy and behavioral modification. Lifestyle changes (including avoiding yelling, adequate hydration, and a healthy diet). Microlaryngoscopic surgery is rarely performed for failed therapy due to high recurrence rate. 

Healthy, normal vocal cords

Anatomy and Physiology of the Normal Larynx. University of Nebraska Medical Center Department of Otolaryngology, Head and Neck Surgery. Accessed 18 Jan 2023. 

Bilateral vocal cord nodules 

Benign lesions. University of Nebraska Medical Center Department of Otolaryngology, Head and Neck Surgery. Accessed 18 Jan 2023. 

Further Reading:
https://www.chop.edu/conditions-diseases/vocal-cord-nodules
https://www.ncbi.nlm.nih.gov/books/NBK534635/
https://voice.weill.cornell.edu/voice-disorders/nodules
https://app1.unmc.edu/medicine/heywood/laryngealdisease/Data/normalfunction.htm
https://app1.unmc.edu/medicine/heywood/laryngealdisease/Data/benignlesions.htm

Written by: Phuong, Alexandria, Bao