Do vocal cord nodules require surgery?

Written by Deng Bang Yu
Otolaryngology
Updated on September 01, 2024
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Vocal cord nodules refer to symmetrical nodular elevations that appear on the free edges of both vocal cords. These nodules are mostly grain-like or granular protrusions. Vocal cord nodules are often caused by incorrect pronunciation, overuse of the voice, or screaming loudly, which are inappropriate vocal habits. Generally, most vocal cord nodules will disappear on their own after resting the voice, speaking less, and using the voice correctly. Therefore, as explained above, vocal cord nodules do not require surgical treatment. Surgery is only necessary if the vocal cord nodules continue to develop uncontrollably, evolving into vocal cord polyps or other pathological changes.

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Written by Li Mao Cai
Otolaryngology
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The best treatment method for vocal cord nodules

Vocal cord nodules are often caused by excessive talking, loud speaking, or overuse of the voice. They are commonly found in individuals who frequently use their voices in their professions, such as salespeople, teachers, and singers. The best treatment approach is to address the root cause, which involves speaking less and using proper vocal techniques. This is the optimal treatment plan. However, this method may not always be effective, as some people, due to their occupational needs, cannot fully achieve vocal rest. If vocal rest does not effectively treat the condition, surgical intervention may then be necessary. During the treatment period, after diagnosing vocal cord nodules, vocal rest is the preferred approach. If vocal rest is ineffective or does not fully resolve the nodules, surgery may be required as a follow-up treatment.

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Written by Yao Jun
Otolaryngology - Head and Neck Surgery
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How to treat vocal cord nodules

Vocal cord nodules, also known as singer's nodules, are typically located at the junction of the anterior and middle thirds of both vocal cords, featuring symmetrical nodular protrusions. They are more commonly found in individuals who use their voices professionally, such as singers, teachers, or other vocations that involve frequent shouting, as well as in children. Prolonged or improper use of the voice is a major cause of this condition. Therefore, during treatment, voice rest is primarily advised. Early stage vocal cord nodules can spontaneously resolve with sufficient vocal rest, and nodules in children often disappear naturally during puberty. Additionally, medication can be used for treatment, such as traditional Chinese medicines, including Jin Sang San Jie Wan and Kai Yin Pills. If conservative treatment fails, surgical removal of the vocal cord nodules under fiberoptic laryngoscopy can be performed, followed by a two-week voice rest period. Post-surgery, it is recommended to inhale medicated vapors, avoid spicy and irritating foods, drink plenty of water, avoid staying up late, and refrain from excessive voice use or shouting.

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Written by Yao Jun
Otolaryngology - Head and Neck Surgery
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Can vocal cord nodules heal by themselves?

Vocal cord nodules, also known as singer's nodules, typically involve symmetrical nodular protrusions at the junction of the anterior and middle thirds of both vocal cords. This condition is commonly seen in individuals who use their voices professionally or excessively, such as actors, teachers, individuals in vocations that require shouting, and children. The primary cause of this condition is attributed to long-term excessive or improper use of the voice. Early stage vocal cord nodules can disappear by allowing the vocal cords to rest sufficiently through voice rest; in children, vocal cord nodules might disappear after puberty. If these nodules do not resolve with conservative treatment and voice rest, medical treatment or surgery may be necessary.

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Written by Zhang Jun
Otolaryngology
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Scraping therapy is effective for vocal cord nodules

Vocal cord nodules are ineffective with scraping therapy. Vocal cord nodules are bilateral vocal fold lesions caused by improper voice use over long periods, excessive strain, loud yelling, or irritation from gastric acid reflux. They can cause persistent hoarseness in the patient, progressively worsening over time. If a patient experiences long-term hoarseness without improvement, it is essential to undergo an examination with an electronic laryngoscope at a hospital. This can reveal a symmetrical, smooth-surfaced, protein-based abnormal growth at the anterior-middle third of both vocal cords, leading to incomplete closure of the vocal folds, which results in hoarseness. Treatment requires surgical intervention, as scraping therapy is ineffective. The procedure involves the removal of the vocal cord nodules under general anesthesia with a surgical laryngoscope. Post-surgery, antibiotics are used to prevent local infection and recovery is typically within about a week for hospital discharge.

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Written by Zhang Jun
Otolaryngology
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Symptoms of cancerous changes in vocal cord nodules

The possibility of malignant transformation of vocal cord nodules is very small. If cancerous transformation occurs, the patient will experience persistent hoarseness, as well as symptoms such as difficulty in breathing, difficulty in swallowing, persistent cough, and blood in the sputum. Vocal cord nodules are caused by prolonged improper use of the voice, shouting, or long-term irritation of the vocal cords by acid reflux. If patients do not undergo surgical treatment, the vocal cord nodules may continue to enlarge and undergo cellular mutations, leading to malignancy. At this point, patients may find cauliflower-like neoplasms or ulcers on the surface of the vocal cords. They will experience hoarseness, difficulty breathing, and difficulty swallowing. At this stage, it is necessary to perform a local biopsy. If a malignant tumor is confirmed, localized surgical treatment can lead to improvement.