THROAT - Vocal Nodules

Introduction to vocal nodules:

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 andloudness.

Pathology of Vocal Nodules.

  • 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 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

What is the treatment of vocal nodules?

Medical treatment:

  • Voice rest and Vocal hygiene
  • Voice therapy
  • Steam inhalation helps to reduce oedema around vocal cords in cases of laryngitis

Surgical treatment:

This is the treatment of choice for well formed vocal nodules

  • Excision by Microlaryngoscopy
  • Excision by Laser Microlaryngoscopy



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