How to treat vocal cord nodules?

Written by Zhang Jun
Otolaryngology
Updated on January 17, 2025
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Vocal cord nodules are caused by improper, prolonged use of the voice, excessive strain, or shouting loudly, resulting in bilateral vocal cord lesions. They can lead to persistent hoarseness in patients, with intermittent exacerbations. Vocal cord nodules cause incomplete closure of the glottis. Examination with an electronic laryngoscope reveals symmetrical, pale, nodular protrusions on the anterior middle third of both vocal cords. In terms of treatment, vocal cord nodules can initially be managed conservatively. This involves complete vocal rest for one week, combined with nebulized inhalations to reduce local congestion and edema. After one week, if there is no improvement and the nodules persist, the patient may require excision surgery under supported laryngoscopy. The surgery requires hospitalization, general anesthesia, and patients typically recover and are discharged within a week after the operation.

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Written by Deng Bang Yu
Otolaryngology
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Do vocal cord nodules require surgery?

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 Rui
Otolaryngology
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Vocal cord nodules atomization effect

Vocal cord nodules are a relatively common otolaryngological condition. The primary clinical symptoms are hoarseness. In terms of treatment, nebulization can be considered. Most patients respond well to nebulization, which can significantly improve hoarseness. Some patients may experience a gradual reduction in the nodules, but individual differences exist. For some patients, nebulization alone may not be effective, and they may need to combine it with oral medication. Regular laryngoscopic check-ups are necessary during the treatment process to monitor changes in the nodules. A small number of patients, who do not respond well to conservative treatments, might require surgical removal, but there is still a possibility of recurrence after surgery. (Please follow the guidance of a professional physician for medication use.)

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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 Li Mao Cai
Otolaryngology
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Conservative treatment methods for vocal cord nodules

Conservative treatment methods for vocal cord nodules mainly include voice rest and medication support. The underlying cause of vocal cord nodules is fairly clear, often due to excessive talking or improper voicing, and is commonly seen in individuals who speak frequently, such as teachers, salespeople, singers, etc. Therefore, treatment targeting the cause involves speaking less and ensuring voice rest, which should be maintained for about 2-4 weeks. The better the implementation of voice rest, the quicker the recovery. During voice rest, it is also important to have a light diet, avoid spicy and stimulating foods, and steer clear of environments with smoke and alcohol. Additionally, nebulized inhalation therapy and some traditional Chinese medicines can be used to support treatment effectiveness. Commonly used medications for nebulization include Budesonide, and typical traditional Chinese medicines include Jin Sou San Jie Wan and Jin Sou Qing Yin Wan.

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Written by Li Mao Cai
Otolaryngology
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Treatment methods for vocal cord nodules

The treatment is primarily divided into conservative treatment and surgical treatment. Generally, conservative treatment is implemented first. The main strategy of conservative treatment is vocal rest, which entails speaking as little as possible, typically for a duration of two to four weeks. Concurrently, medication is administered, often through nebulized inhalation therapy. The second approach is surgical treatment, which is considered if the conservative treatment does not yield satisfactory results, or if the condition worsens. At this point, surgical treatment of vocal cord nodules is typically performed using support laryngoscopy, microscopy, and either laser or fiber instruments to remove the vocal cord nodules. Post-surgery, a period of vocal rest is necessary for recovery, also lasting two to four weeks. During the recovery period, it is important to speak less, use proper phonation, avoid smoking and alcohol, follow a light diet, and steer clear of spicy and irritating foods.