• thyroid disease.• Smokers.• caffeine use, and/or use of prescription or over-the-counter (OTC) medications.• vocal hygiene.• most often observed in women aged 20-50 years
Signs & Symptomshoarsenessbreathinessa "scratchy" voiceharshnessshooting pain from ear to eara "lump in the throat" sensationneck paindecreased pitch rangevoice and body fatigue
Diagnosing1- a voice evaluation by a speech-language pathologist (SLP).2- possibly a neurologicalexamination.3- Videostrobo-laryngoscopy
Treatment-Keep away from predisposingfactors. ( voice rest ).-Speech therapy.- Surgical intervention . If nodule arevery large or have existed for a longtime. (Microlaryngoscopic removal )
Complications-tongue numbness.- altered taste.-minor trauma to the teeth, oralcavity, and pharynx during rigidlaryngoscopy.- worsened voice quality, bleeding,infection
Outcome & prognosis-treatment often results in vocalimprovement.- In 1996, Bastian reported his personalsurgical series of 62 singers who hadundergone microsurgery , Reportedly,all singers within the series were ableto return to a level of public singing atleast equal to that experiencedpreoperatively.