Vocal cord nodule
| Vocal voice nodule | |
|---|---|
| Other names | Vocal fold nodules, Vocal nodules |
| Specialty | Otorhinolaryngology |
Vocal cord nodules are bilaterally symmetrical benign white masses (nodules) that form at the midpoint of the vocal folds.[1] Although diagnosis involves a physical examination of the head and neck, as well as perceptual voice measures, visualization of the vocal nodules via laryngeal endoscopy remains the primary diagnostic method.[2][3]
Vocal fold nodules interfere with the vibratory characteristics of the vocal folds by increasing the mass of the vocal folds and changing the configuration of the vocal fold closure pattern.[1][2][4] Due to these changes, the quality of the voice may be affected.[1] As such, the major perceptual signs of vocal fold nodules include vocal hoarseness and breathiness.[4][5] Other common symptoms include vocal fatigue, soreness or pain lateral to the larynx, and reduced frequency and intensity range.[1][4][5] Airflow levels during speech may also be increased.[1] Vocal fold nodules are thought to be the result of vocal fold tissue trauma caused by excessive mechanical stress, including repeated or chronic vocal overuse, abuse, or misuse.[1][2][5] Predisposing factors include profession, gender, dehydration, respiratory infection, and other inflammatory factors.[1][2]
For professional voice users as well as individuals who frequently experience hoarseness, vocal hygiene practices are recommended for the prevention of vocal fold nodules and other voice disorders.[6] Vocal hygiene practices include three components: regulating the quantity and quality of voice use, improving vocal fold hydration, and reducing behaviours that jeopardize vocal health.[6] About 10% of nodules resolve on their own, which is more likely if they are smaller and the onset more recent.[7] Treatment of vocal fold nodules usually involves behavioural intervention therapy administered by a speech–language pathologist. In severe cases, surgery to remove the lesions is recommended for best prognosis.[8][9] In children, vocal fold nodules are more common in males; in adults, they are more common in females.[10][5]
- ^ a b c d e f g Verdolini, Katherine; Rosen, Clark A.; Branski, Ryan C., eds. (2014). "Vocal Fold Nodules (Nodes, Singer's Nodes, Screamer's Nodes". Classification Manual for Voice Disorders-I. Psychology Press. pp. 37–40. ISBN 978-1-135-60020-4.
- ^ a b c d Johns, Michael M. (2003). "Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts". Current Opinion in Otolaryngology & Head and Neck Surgery. 11 (6): 456–61. doi:10.1097/00020840-200312000-00009. PMID 14631179. S2CID 45661781.
- ^ Pedersen, Mette; McGlashan, Julian; Pedersen, Mette (2012). "Surgical versus non-surgical interventions for vocal cord nodules". The Cochrane Database of Systematic Reviews. 2012 (6): CD001934. doi:10.1002/14651858.CD001934.pub2. PMC 7064879. PMID 22696326.
- ^ a b c Colton, Raymond H.; Casper, Janina K.; Leonard, Rebecca (2006). "Nodules". Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment. Lippincott Williams & Wilkins. pp. 100–4. ISBN 978-0-7817-4239-9.
- ^ a b c d Kunduk, Melda; McWhorter, Andrew J (2009). "True vocal fold nodules: the role of differential diagnosis". Current Opinion in Otolaryngology & Head and Neck Surgery. 17 (6): 449–52. doi:10.1097/MOO.0b013e3283328b6d. PMID 19779347. S2CID 8834120.
- ^ a b Leonard, Rebecca (2009). "Voice therapy and vocal nodules in adults". Current Opinion in Otolaryngology & Head and Neck Surgery. 17 (6): 453–7. doi:10.1097/MOO.0b013e3283317fd2. PMID 19741535. S2CID 42269683.
- ^ Simpson, Blake; Rosen, Clark (2008). "Vocal Fold Nodules". Operative Techniques in Laryngology. Springer. pp. 105–7. doi:10.1007/978-3-540-68107-6_16. ISBN 978-3-540-25806-3. S2CID 234161002.
- ^ Béquignon, Emilie; Bach, Christine; Fugain, Claude; Guilleré, Lia; Blumen, Marc; Chabolle, Frédéric; Wagner, Isabelle (2013). "Long-term results of surgical treatment of vocal fold nodules". The Laryngoscope. 123 (8): 1926–30. doi:10.1002/lary.23768. PMID 23757348. S2CID 36758075.
- ^ Nakagawa, Hideki; Miyamoto, Makoto; Kusuyama, Toshiyuki; Mori, Yuko; Fukuda, Hiroyuki (2012). "Resolution of Vocal Fold Polyps With Conservative Treatment". Journal of Voice. 26 (3): e107–10. doi:10.1016/j.jvoice.2011.07.005. PMID 22082864.
- ^ Dobres, Rachel; Lee, Linda; Stemple, Joseph C.; Kummer, Ann W.; Kretschmer, Laura W. (1990). "Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists". Journal of Speech and Hearing Disorders. 55 (3): 526–32. doi:10.1044/jshd.5503.526. PMID 2199731.