Vocal nodules, also known as singer's nodes or screamer's nodes, are benign growths that develop on the vocal cords due to vocal trauma from prolonged periods of speaking at unnatural low tones or high intensities. They most commonly affect teachers, actors, vendors, pop singers, and school-going children who are too assertive and talkative. Pathologically, vocal abuse or misuse causes edema, hemorrhaging, and fibrosis in the vocal cord tissue, forming hardened nodules on the free edge of the vocal cords at their point of maximum vibration. Patients experience hoarseness of voice, vocal fatigue, and neck pain with prolonged phonation. Treatment involves voice therapy and re-education for mild cases

1. PRESENTED BY:-
PRAJWAL GUPTA
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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.