Vocal Cord Nodules

Vocal cord nodules, also called vocal fold nodules, are benign, symmetrical white growths that form at the midpoint of both vocal folds, typically diagnosed by direct visualization of the larynx through endoscopy along with physical examination and assessment of the voice. They arise from vocal trauma caused by excessive mechanical stress on the vocal folds, including repeated or chronic overuse, misuse, or abuse of the voice, with dehydration, respiratory infection, and inflammatory conditions as contributing factors. They produce hoarseness, breathiness, vocal fatigue, soreness in the neck, and a reduced range of pitch and loudness. In children they occur about twice as often in boys, particularly those who scream or shout frequently, while in adults they are more common in women, especially those with outgoing personalities or who sing often. About ten percent resolve on their own, particularly smaller and more recently formed nodules, and standard treatment is behavioral voice therapy from a speech-language pathologist, with surgery reserved for more severe or persistent cases.