Vocal cord nodules

This leaflet has been written to help you understand the symptoms you may be experiencing, and to try to answer some of the questions you may have.

What are vocal nodules?

Vocal cord nodules are tiny bumps which occur on the vocal cords as a result of excessive friction. Over time they develop from a slight reddening at first, to a swelling and then definite nodules. Vocal cord nodules are often compared to calluses on the hands. These develop from blisters which continue to be rubbed in the same place. Vocal cord nodules usually form as a pair – one on each vocal cord, opposite each other.

What are the causes of vocal nodules?

Vocal nodules occur as a result of vocal misuse and abuse. Vocal nodules can be caused by:

• Continued use of the voice in an excessive manner
• Shouting
• Screaming
• Talking over background noise
• Singing
• Excessive coughing and throat clearing
• Poor vocal hygiene, such as insufficient water intake, smoking and acid reflux

What are the symptoms of vocal nodules?

Vocal cord nodules cause several symptoms, depending on the type and size of the nodules. These include:

Voice changes

• Gradual onset of hoarseness, initially episodic but can become constant
• Breathy / rough voice quality
• Effortful voice with voice breaks

Other symptoms

• Throat discomfort
• Throat clearing
• Deterioration of voice with use
• Lowered pitch

How will my diagnosis be confirmed?

You will be seen by a member of the ear, nose and throat (ENT) team who will look at how your vocal cords are moving. A speech and language therapist may also be present and assist in the diagnostic process.

What treatment is available for vocal nodules?

Voice therapy is the preferred choice of treatment for nodules to help reduce irritants, change vocal behaviours and regular voice therapy to improve your voice quality. In some cases, surgical intervention by the ENT team may be necessary.

What can I do to help my symptoms?

You should follow exercises and advice given to you by the ENT doctors and the speech and language therapist to help reduce your symptoms and improve your voice quality.

You can take the following steps to improve your voice symptoms:

Alter the way you use your voice:

• Avoid excessive voice use
• Try not to talk or shout over background noise
• Rest your voice whenever possible
• Do not force your voice

Other suggestions:

• Reduce / stop smoking
• Drink plenty of fluids – approximately two litres per day
• Limit alcoholic, caffeinated and fizzy drinks
• Avoid dry, dusty and smoky environments as this could irritate your vocal cords
• Minimise throat clearing and coughing
• See your GP if you are experiencing acid reflux / heartburn

If you have any further questions about vocal nodules please ring your speech and language therapist on 01223 216200 or contact your GP.