Vocal Nodule (Vocal Cord Nodule) and Voice Therapy

Vocal fold (vocal cord) nodules, which can be successfully treated with voice therapy, are among the most common vocal fold lesions that cause hoarseness in adults and children. Vocal fold nodules have the strongest mucosal contact; They are formed at the junction of the anterior – middle parts of the 1/3 of the vocal folds.

In patients with vocal fold nodules, the voice is hoarse, rough, muffled, and decreases in intensity during phonation due to air leakage.

Generally, vocal nodules are more common in men in children and in young women in adults. The reason why it is observed more frequently in adult women; In females, the vibrating part of the vocal folds is shorter in length and the impact stress is higher at the midpoint of the membranous part. In addition, the frequency of vocal nodules is higher in people who speak a lot in society and perform their profession with their voice, such as teachers, lawyers, sound artists, actors, call center workers, compared to other occupational groups.

The size of the nodules can be observed to varying degrees from the size of a pinhead to the size of a pea. The nodules are pinkish in color, small and edematous in the early period. Chronic nodules are typically white in color. However, the flexibility of the vocal folds (vocal cords) has decreased and the amplitude of the voice has decreased.

There are many studies in the literature examining the factors that may cause the formation of vocal fold nodules.

Although incorrect or excessive use of voice is generally accepted as the main cause of nodule formation, behaviors such as chronic coughing or excessive throat clearing are also effective in nodule formation. After nodule formation, the continuation of inappropriate vocal behavior may exacerbate the situation. For example, if the closure between the vocal folds is not complete during phonation, closure of the ventricular vocal folds (false vocal cords) or sphincteric contraction may be a significant attempt to compensate for the glottic opening, resulting in excessive airflow.

Apart from all these, it has been reported in many studies in the literature that other factors such as insufficient hydration, laryngopharyngeal reflux, smoking and stress may also be effective in the formation of nodules.

In line with all these factors; Vocal nodules can be treated by providing voice hygiene, acquiring appropriate habits and voice therapy.

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