Vocal Nodules
Bilateral VF Nodules
Vocal nodules are one of the most common benign (non-cancerous) vocal fold lesions. Nodules are typically the result of voice abuse and misuse over a period of time. The chronic impact on the vocal fold mucosa caused by inappropriate phonotory habits, often result in callous-like lesions. These lesions are usually bilateral (occur on both vocal folds) and vary in size from as small as a pinhead to as large as a pea. Nodules can occur at any age, but occur frequently in both male and female children and in female adults. They also occur in untrained singers using inappropriate vocal technique. Nodules are rarely present in adult males. The effects on the voice vary depending upon how big the lesions are, how long they have been on the vocal folds, and any accompanying laryngeal inflammation.
The first line of management for vocal nodules is voice therapy. When nodules are removed surgically without the benefit of voice rehabilitation therapy, they may quickly recur. Even the chronic nodule may resolve when the appropriate management program is followed. When nodules do not respond to therapy in the patient who has been compliant with voice therapy, then surgical management may be required, to be followed by post-surgical voice rehabilitation.
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