nodule of the vocal cords and its treatment

1. PRESENTED BY:-
PRAJWAL GUPTA
89

2. Vocal nodules
(Singer’s
or
Screamer’s nodes)
o They appear symmetrically on the free edge of
vocal cord, at the junction of anterior one-
third, with the posterior two-thirds, as this is
the area of maximum vibration of the cord and
thus subject to maximum trauma
o Their size varies from that of pin-head to half
a pea.
o They are the result of vocal trauma when
person speaks in unnatural low tones for
prolonged periods or at high intensities.
o They mostly affect teachers, actors, vendors or
pop singers. They are also seen in school
going children who are too assertive and
talkative.

3.  Pathologically, trauma to the vocal cord in the form of
vocal abuse or misuse causes oedema and
haemorrhage in the submucosal space
 This undergoes hyalinization and fibrosis. The
overlying epithelium also undergoes hyperplasia
forming a nodule.
 In the early stages, the nodules appear soft, reddish
and oedematous swellings but later they become
greyish or white in colour.

4. SIGN AND SYMPTOMS
Patients with vocal nodules
complain of hoarseness of voice.
Vocal fatigue and pain in the neck
on prolonged phonation are other
common symptoms.

5. TREATMENT
 Early cases of vocal nodules can be treated
conservatively by educating the patient in proper use
of voice.
 With this treatment, many nodules in children
disappear completely.
 Surgery is required for large nodules or nodules of long
standing in adults.
 They are excised with precision under operating
microscope either with cold instruments or laser
avoiding any trauma to the underlying vocal ligament .
 Speech therapy and re-education in voice production
are essential to prevent their recurrence.