Nodules on Vocal Cords

Vocal cord nodules are lumps or calluses that develop on the vocal cords. They look like tiny swollen areas on the vocal cord sides and are often caused due to prolonged vocal trauma without any rest intervals.Nodules can develop on one of the vocal cords or both.

The vocal cords are made of two muscle sets present within the throat. They control the quantity of air that enters the cord from the lungs and thus allow us to make sounds when singing or talking, etc.

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The vocal cords or vocal folds are not only strings present in the voice box. In fact, they are tissue folds with a soft, fine, and fragile outer lining that can be easily injured.When speaking or singing, the vocal cords vibrate hundreds of times per second, thereby placing increased stress and pressure on the delicate lining. Use of the voice for prolonged periods, especially in dry or smoky environments, can cause the lining to inflame and swell.If the vocal cords are not rested, then the swelling becomes more solid over time, till it converts into a nodule.

Nodules are a tissue mass or a lumpy cluster that form on or below the skin. It is a Latin word which means ‘knots.’Nodules are of different types, including thyroid nodules, rheumatoid nodules, and vocal cord nodules, etc. Even though they are harmless, they can adversely affect the function of the host organ as well as cause discomfort. With regards to nodules on vocal cords, the swellings inhibit vocal folds and prevent it from creating rapid changes in the air flow instrumental for speech creation. Vocal cord nodules do not trigger the onset of laryngitis.

Symptoms of nodules on vocal cords

Change in voice quality is the most common symptom of nodules on vocal cords. During the early stages, the vocal cord area may exhibit the development of swollen tissues patches, which eventually form nodules in the later stages.

Some of the common signs and symptoms of nodules on vocal cords are as follows:

  • Scratchy and rough voice
  • Hoarseness
  • Production of speech may cause pain
  • Fatigue of the voice and body
  • Speech features harshness
  • Pain in neck
  • Breaks in voice or vocal sounds
  • The pitch range may be low
  • Intense pain in ear
  • Some persons with nodules on vocal cords may experience voice initiation delays, i.e., the sounds may produce a few seconds after talking.
  • Lumpy sensation in the throat; this may make the patient to clear his/her throat on a frequent basis.

Pain may not be evident when a vocal cord nodule is growing. Neck pain may be felt when the nodule is grown fully. Some patients may also experience sharp pain from one ear to the other. Continual growth of the nodule may cause increased tiredness of the voice even when the patients talks just a little.

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Singers find vocal cord nodules to be particularly discomforting and troublesome. This is because the condition causes them to lose their voice consistency. The range of voice also tends to deteriorate which poses problems in singing loudly.

Causes of nodules on vocal cords

Nodules on vocal cord are usually caused due to some kind of misuse, overuse, or abuse of the vocal cords.Whenever voice is used, the vocal cords close and open to facilitate the passage of air from the lungs into it, thereby producing sound. Any kind of irritation of the vocal cords can lead to enlargement of one or both of them,thus causing nodules on vocal cords. Subsequently the cords not close or open normally, leading to problems in the free flow of air from the lungs and the associated symptoms of vocal cord nodules.

Some of the common ways in which vocal cords can be abused, misused, or irritated are listed below:

  • Coughing
  • Cheerleading
  • Loud talking
  • Screaming or yelling
  • Stress
  • Excess shouting
  • Singing for prolonged periods
  • Smoking
  • Increased alcohol or caffeine intake
  • Heartburn
  • Tense or stressed muscles in the throat
  • Vocal cord dryness
  • Allergic reactions that affect the throat

Singers, children, auctioneers, cheerleaders, and orators are more vulnerable to the formation of nodules on vocal cords than others. Also, women are more prone to it than men.

Treatment of nodules on vocal cords

Treatment of nodules on vocal cords is dependent on correct diagnosis of the underlying cause and elimination of the factors that irritate the cords. For example, if nodules are caused by heartburn then the digestive condition is treated with relevant medications.

  • Mild cases of vocal cord nodules generally tend to disappear on their own when the cords are rested for a sufficient period of time.
  • Moderate instances may be treated with voice rehabilitation involving vocal rest, speech therapy exercises, and vocal training.In speech therapy, volume adjustment and voice pitching, etc. techniques are taught to the patients. Breathing techniques which help reduce the stress on vocal cords may also be taught. These therapies play a role in in preventing further vocal cord damage.
  • Severe cases marked by overgrowth of vocal cord nodules may need surgical removal of the nodules. This treatment option is rarely required.
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