Vocal cord nodules are usually a direct result of overusing the voice. Although they are a dreaded malady for professional singers, they can also occur in teachers, attorneys or others who must constantly use their voices in a job setting. Cheerleaders or construction workers who shout a great deal can get them, and even people who chronically clear their throats or cough can be affected.
Hoarseness and breathiness are the two most common symptoms of nodules. Patients may also experience vocal fatigue, pain around the larynx or a diminished intensity or range in the singing voice. A professional singer may note that he or she can’t hold a note with a single breath as long as they did prior. Typically, the problem will seem worse at the end of the day than in the morning.
Although singers are often quite fearful of vocal cord nodules, the reality is that they can usually be treated without surgery. After diagnosing the exact problem though video stroboscopy, Dr. Korovin often prescribes basic voice conservation, combined with a course of therapy from an outpatient vocal therapist. Although “time off” can be an issue for a singer currently in a Broadway show, for example, Dr. Korovin has often dealt with the apprehensions of producers and others who can be resistant to giving a star a period of needed rest.
Your voice is created when your vocal cords vibrate together. Too much singing or speaking loudly can cause them to swell or bulge, preventing them from meeting properly. Over time, the swelling can turn into a callous or nodule that, unchecked, can grow larger and degrade the voice.
Sometimes poor vocal habits can be a cause of the problem. A voice therapist can often help the professional singer or speaker correct subtle mistakes in vocal technique that cause voice strain. Simple behaviors like increasing hydration can help resolve the problem, while improvements in one’s vocal technique can help minimize the chance that the nodules will ever recur.
Surgery is considered only for nodules that don’t resolve after an adequate course of voice therapy and still cause vocal problems.
In some instances, medications such as steroids can help shrink surrounding inflammation and may allow a professional voice user to get through a particular voice use event. In virtually all cases, voice therapy with a properly trained therapist is needed to achieve long term improvement.