Vocal cord nodule

nodule of the vocal cords and its treatment

1. VOCAL CORD NODULE PRESENTED BY:- PRAJWAL GUPTA 89

2. Vocal nodules (Singer’s or Screamer’s nodes) 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 Their size varies from that of pin-head to half a pea. They are the result of vocal trauma when person speaks in unnatural low tones for prolonged periods or at high intensities. 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 .