Causes and risk factors
Misuse or overuse of voice, singing at a high note at the end of breath can lead to hyperkeratosis of the free edges of true vocal cords. Repeated overuse of the voice causes soft, swollen spots on each vocal cord. These spots grow into harder, callus-like growths called as nodules. The nodules become larger and stiffer the longer the vocal abuse continues. Professional singers, teachers, lecturers, etc., are at a higher risk of developing vocal cord nodules. Housewives who often shout at their children can develop this disease.
Clinical presentation
Patient experiences hoarseness of voice. Voice becomes low pitched. It may become breathy. Singers may notice a loss of vocal range. Vocal fatigue at the end of the day occurs. Small, smooth white colored nodules on both the vocal cords is seen. The nodule may be small, large, cystic, or polypoidal.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Voice evaluation by a specialist is required. Laryngoscopy is done to visualize the nodules.
Treatment
Most patients will be treated with voice therapy where the patient will be trained regarding proper vocal hygiene, hydration, and avoidance of vocal abuse, misuse, and overuse. Septic focuses in the larynx, if any, should be treated. Surgical removal of the nodules, i.e., excision by microlaryngoscopy is undertaken only if the nodules are very large. Laser surgery may also be useful. Voice rest is advised.
Other Modes of treatment
The other modes of treatment can also be effective in treating nodules of vocal cords . Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating nodules of vocal cords.