Vocal Cord Nodules: 8 Things Doctors Want You to Know

  • Middle-aged Latina doctor having conversation with patient in office
    Experts Speak Up About This Common Vocal Condition
    Vocal cord nodules are fairly common among people who make a living with their voice, but anyone can get these nodules. Also called vocal fold nodules or singer’s nodules, these can affect anyone, from a parent cheering on a child’s team to children screaming on a playground. In addition, some outside sources may also put you at risk. For example, allergies and smoking may increase your risk of vocal cord nodules. So can having a condition like gastroesophageal reflux disease (GERD). Here’s what three experts in vocal cord nodules want you to know about preventing and treating the issue.

  • illustration of larynx with labels describing vocal cord, vocal folds, and tracheal cartilage
    1. “Vocal cord nodules are like calluses.”
    We have two vocal cords that vibrate and snap at each other when we make sound. “The harder we push them, the more they snap against each other. You develop a callus at that contact point,” explains Maseih Moghaddassi, MD, an ENT specialist and chief of the Department of Otolaryngology and Head and Neck Surgery at NYU Winthrop Hospital in Mineola, N.Y. And the harder you use or push your voice, the harder and larger the nodule may become.

  • table top humidifier at home
    2. “Vocal cord nodules usually respond to some voice TLC.”
    Just like a callus on your hand may eventually go away if you stop performing the task that caused it, vocal cord nodules can go away once the stress on the vocal cords is eliminated. “A lot of times if you actually rest your voice or go to a speech therapist, non-medical things such as breathing humidified air and drinking a lot of water can solve the problem,” says Dr. Moghaddassi. Don’t whisper though. Whispering also makes your vocal cords vibrate, so they’re not getting a break.

  • Pediatrician, Nurse and Patient
    3. “A vocal cord nodule is not the same as a polyp.”
    “I often have to explain the difference to patients of what vocal fold nodules are versus a vocal fold polyp,” says Brian DeSilva, MD, an assistant professor of otolaryngology at The Ohio State University Wexner Medical Center in Columbus, Ohio. “Even though they are both lesions that occur with vocal trauma and vocal abuse, they behave differently and often are treated differently.” A nodule is like a callus, but a polyp is usually larger and could be caused by other factors, such as smoking.

  • group of children singing in school choir
    4. “Children can get vocal cord nodules.”
    Age and sex don’t matter when it comes to vocal cord nodules. While they are more common among people who use and push their voice every day, such as singers, radio personalities, and preachers, anyone can get them. “We can see them in children who tend to abuse their voice. We can see them in teenagers or adults, people who sing, and people who use their voice a lot, such as teachers or other vocal professionals,” explains Dr. DeSilva. “We see them in people who have to project their voice, such as cheerleaders.”

  • teenage girl smiling with doctor in background
    5. “Vocal cord nodules are not dangerous.”
    “I think some of the biggest misconceptions about vocal cord nodules, or vocal fold nodules, is that patients sometimes think this is a catastrophic diagnosis,” says Michael Z. Lerner, MD, an assistant professor of otolaryngology at Montefiore Health System in Bronx, N.Y. This is especially worrisome for people who use their voices to perform or professionally. “In fact, the nodules have no potential for malignancy or anything like that. Other patients, when they hear the word nodule, assume it's similar to nodules that occur elsewhere in the body. It certainly doesn't have that particular meaning, really.”

  • speech therapist helping teenage patient at clinic
    6. “Surgery is not usually required to treat vocal cord nodules.”
    “We tend to work with speech language pathologists who are part of our team to treat vocal cord nodules,” says Dr. Lerner. Unless surgery is necessary, ENT doctors try to integrate a speech therapy treatment option as a first step. “We have the patient work with a voice therapist at first, see if they can alter their behaviors to try to solve the problem without surgery,” says Dr. Lerner. “Altered behaviors may include quitting smoking, drinking more fluids, and humidifying the air. If someone has an underlying health problem, like gastroesophageal reflux disease (GERD) or allergies, that would also be something to manage as these can make nodules worse.”

  • doctor performing laryngoscopy or preparing for endotracheal tube insertion
    7. “Surgery can cause scarring.”
    “The reason we want to limit surgical intervention is because vocal fold nodules are in essence a scar on the edge of the vocal fold,” explains Dr. DeSilva. Scarring can also affect the quality of the voice. “We want to try to minimize the amount of dissection or surgery we’re doing on a scarred vocal fold. Sometimes surgery is necessary, but the voice therapy, the interventions we do ahead of that are more important leading up to any surgery.”

  • Laryngitis
    8. “If your hoarseness lasts more than a couple of weeks, see your doctor.”
    Not all hoarse voices are signs of vocal cord nodules, but if you’re hoarse for two weeks or more, it’s best to see your doctor for an evaluation. “People certainly can have a hoarse voice from the common cold or other forms of laryngitis,” says Dr. Lerner. “But if it persists beyond two weeks, most doctors would recommend that the patients undergo an examination of their vocal cords to rule out other possibilities.”

Vocal Cord Nodules: 8 Things Doctors Want You to Know
Contributors
  • Maseih Moghaddassi, MD - Healthgrades - Vocal Cord Nodules: 8 Things Doctors Want You to Know
    ENT specialist; chief of the Department of Otolaryngology & Head and Neck Surgery, NYU Winthrop Hospital in Mineola, N.Y.
  • Brian DeSilva, MD - Healthgrades - Vocal Cord Nodules: 8 Things Doctors Want You to Know
    Assistant professor of Otolaryngology at The Ohio State University Wexner Medical Center in Columbus, Ohio
  • Michael Z. Lerner, MD - Healthgrades - Vocal Cord Nodules: 8 Things Doctors Want You to Know
    Assistant professor of Otolaryngology at Montefiore Health System in Bronx, N.Y.

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jun 10
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