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?
- Voice rest and Vocal hygiene
- Voice therapy
- Steam inhalation helps to reduce oedema around vocal cords in cases of laryngitis
This is the treatment of choice for well formed vocal nodules
- Excision by Microlaryngoscopy
- Excision by Laser Microlaryngoscopy