Early symptoms of vocal cord nodules

Written by Yao Jun
Otolaryngology - Head and Neck Surgery
Updated on September 16, 2024
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Vocal cord nodules, also known as singer's nodules, typically present as symmetrical nodular protrusions at the junction of the anterior and middle one-thirds of the vocal cords, with a relatively broad base. The main symptom is hoarseness of voice. Initially, the hoarseness is mild, characterized by a rough voice or nearly normal voice, such as when the voice is overused and feels fatigued, leading to intermittent bouts of hoarseness. Over time, the symptom of hoarseness worsens, progressing from intermittent to persistent hoarseness, affecting singers who cannot sing and teachers who are unable to teach. Examination with a laryngoscope may reveal small nodular protrusions on the anterior-middle one-third of the vocal cords, with incomplete closure of the glottis.

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Written by Li Rui
Otolaryngology
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Can vocal cord nodules be treated without surgery?

Vocal cord nodules are a relatively common otolaryngological condition. In treatment, most patients may not require surgery. Generally, it is recommended to first visit an otolaryngologist for a laryngoscopic examination to assess the severity of the vocal cord nodules. If the nodules are small and the symptoms of hoarseness are not particularly severe, treatment usually involves conservative medication, commonly oral medications and nebulization therapy. In addition, voice rehabilitation training can be conducted. Many patients experience gradual improvement in voice hoarseness and reduction of the vocal cord nodules through this treatment. Some patients may even see the nodules disappear, but regular follow-up visits are necessary as there is a possibility of recurrence.

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Written by Li Rui
Otolaryngology
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Is the surgery for vocal cord nodules uncomfortable?

Surgery for vocal cord nodules is not particularly uncomfortable, and as of now, it is not the first-choice treatment option. In fact, most patients can consider conservative treatment. This generally involves oral medications and nebulization therapy, and voice rehabilitation training can also be considered. Most patients can effectively control and alleviate their condition after standardized conservative treatment. If the effects of standardized conservative treatment are not satisfactory, surgery may be considered. The current surgical options include microlaryngoscopic surgery or vocal cord nodule excision under fiberoptic laryngoscopy, both of which are minimally invasive and cause minor damage. General anesthesia can also be considered; during the surgery, patients do not feel particularly uncomfortable. After the surgery, it mainly requires voice rest and continuing with nebulization therapy.

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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 Li Rui
Otolaryngology
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How should vocal cord nodules be treated?

The treatment of vocal cord nodules mainly prioritizes conservative management, focusing on pharmacotherapy and simultaneously recommending voice training. Regarding medications, oral traditional Chinese medicines are commonly used, along with inhaled corticosteroids, generally requiring one to two weeks of treatment. Additionally, voice training is necessary to avoid excessive voice use, as it can exacerbate symptoms of hoarseness and lead to recurrent vocal cord nodules. If standardized medication treatments fail and severe hoarseness prevails, a small proportion of patients might consider undergoing vocal cord nodule removal surgery under laryngoscopy. Overall, surgery is not the first option, but its results are relatively definitive.

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Written by Xu Qing Tian
Otolaryngology
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Can vocal cord nodules turn into cancer?

Patients with vocal cord nodules usually do not undergo cancerous changes. The main causes of vocal cord nodules are related to improper use of the voice, excessive vocalization, and other factors. The pathological basis for the formation of vocal cord nodules involves edema in the Reinke's layer of the vocal cord mucosa, causing symmetrical hyperplasia of the vocal cords on both sides. The main symptoms in patients are hoarseness and difficulty in producing high-pitched sounds. The primary treatments for patients with vocal cord nodules currently include medication and surgery. Additionally, it is important for patients to protect their voice in daily life, practice voice rest, and reduce unhealthy habits like smoking and alcohol consumption to help prevent the occurrence of vocal cord nodules. (Medication should be used under the guidance of a doctor.)