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What are Vocal Cord Nodules? (Symptoms, Causes, and Treatment)

May 22nd, 2020 | 5 min. read

By Michael P Underbrink, MD

Vocal cord disorders can not only impact your vocal cords, but your voice and ability to talk, too. Vocal cord nodules affect both boys and girls of any age and commonly cause voice problems in both adults and children.

vocal cord nodules (2)

What are Nodules of the Vocal Cords?

Vocal cord nodules are defined as growths that grow on your vocal cords. But, are vocal cord nodules dangerous? They're benign (non-cancerous) bumps, and can be likened to calluses you get on your hands.

Your next question may be, "can vocal cord nodules become cancerous?" Typically, benign nodules go away if you practice voice therapy or rest your voice. It's rare that you would need vocal cord nodules surgery. 

Vocal nodules are also called "vocal fold" nodules by doctors and "Singer's nodules" since individuals can inadvertently "abuse" their vocal cords when they use their voice regularly and cause these growth formations along with other related voice problems.


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Symptoms of Vocal Cord Nodules

Some vocal cord nodules symptoms are:

Voice Changes

Vocal nodules cause voice changes, making it:

  • Tired-sounding

  • Hoarse

  • Scratchy or raspy

  • Lower-pitched than normal

  • Break or crack

  • Limited singing range

  • Breathy

Singers can have a difficult time achieving higher octaves since nodules decrease their range. Some individuals can actually lose their voice completely.


Another common symptom of voice nodules is pain. It might feel like:

  • Neck pain

  • A pain that shoots from ear to ear

  • A lump stuck in the throat


Other potential vocal nodules symptoms include:

  • Constantly having to clear your throat

  • Coughing

  • Tiredness


What Causes Nodules on Your Vocal Cords?

Your vocal cords are V-shaped tissue bands that run down your voice box in the middle. When you sing or talk, the air coming from your lungs is forced up through your vocal cords, making them vibrate open.

If you use your voice incorrectly or overuse it, it could aggravate your vocal cords. And, over time, the aggravated areas harden, forming little callouses textures. They'll continue growing if you don't give your voice some time to rest.

They can also keep your vocal cords from vibrating as they should and this can change the tone and pitch of your voice.

Typically, nodules affect individuals who talk a lot or sing, like:

  • Coaches

  • Cheerleaders

  • Teachers

  • Radio hosts

  • Preachers

  • Salespeople

Individuals develop voice nodules for other reasons other than overuse. A few other potential vocal cord nodules causes include:

  • Sinusitis

  • Smoking

  • Medication side effects

  • Allergies

  • Hypothyroidism

  • Regular alcohol use

  • Tensing your muscles while talking

Anybody can develop vocal nodules, including kids. However, these growths have a higher chance of forming in women who are between 20 and 50 years old and in boys. This increased risk in these certain groups might be due to their larynx size.


How to Heal Nodules on Vocal Cords 

You'll see a doctor for a diagnosis and treatment.


Diagnosis of Vocal Cord Nodules

Ear, nose, and throat (ENT) doctors are typically who you would see if you have vocal cord nodules. They'll first take your medical history. They'll then inspect your vocal cords and listen to the quality of your voice. They often use a small mirror, which they hold in the back of your mouth. ENT physicians might use a flexible, small lighted tube and camera to get a better view. They'll insert the tube through your nose to your larynx.

The doctor will have you make specific sounds so they can see your vocal cords in action. They might videotape the examination to allow them to analyze it later on. This is pretty much all they require to provide you with a diagnosis for vocal cord nodules.

Sometimes, they might suggest an acoustic analysis which is a series of testing that allows the doctor to measure your voice quality, including it's:

  • Range 

  • Intensity

  • Pitch stability

Often, this testing is used when you have a growth on your vocal cords that require surgical removal or when your vocal cords are paralyzed. Using the results of the tests, both the doctor and voice therapists can gauge the amount of improvement following treatment.

Larynx cancer can look much like a contact ulcer or noncancerous growth. If the doctor finds an abnormality on your vocal cords, they might do a biopsy. This is where they remove a tiny sample of the impacted vocal cord tissue to have it examined in a lab.

Other tests might be required like computed tomography (CT) scans in some vocal cord cancer or paralysis cases.

Treatment of Vocal Cord Nodules

Treatment begins with resting your vocal cords. You'll have to avoid yelling, singing, and whispering to provide the nodules time to heal and to bring down swelling. The doctor will let you know how long the rest period should be.

Another part of the treatment is voice therapy. A speech-language pathologist (SLP) will show you how to safely use your voice to keep you from overusing it later on.

Receive treatment for any health conditions that might have caused your vocal nodules like:

  • Allergies

  • Acid reflux

  • Thyroid problems

  • Sinusitis

If after several weeks your vocal nodules don't heal or they're extremely large, you might require surgery to have them removed.  

Phonomicrosurgery is used for treating vocal nodules. The surgeon uses a microscope and tiny instruments to remove nodules without the surrounding healthy tissue becoming damaged.

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Self-Care, Prevention, and Management of Vocal Cord Nodules

To prevent future nodules, you'll want to address the different factors causing them like:

  • Stress

  • Smoking

  • Overuse


Stress is a contributor to vocal nodules. When you're under stress, you might tighten the muscles in your neck and throat.

You can relieve stress with various relaxation techniques like:

  • Yoga

  • Meditation

  • Guided imagery

  • Deep breathing


If you want to decrease how much you smoke or quit it altogether, ask the doctor about different techniques like counseling or medication.  Smoke from cigarettes irritates and dries out your vocal cords and prevents them from properly vibrating when you speak or sing.

Smoking can also lead to damaging stomach acid coming back up into your throat, irritating it.

Voice Overuse

See an SLP to learn techniques to care for your voice. An SLP can teach you how to make voice adjustments when you sing or talk to prevent injury to your vocal cords.

If the doctor does recommend voice therapy, the first follow-up appointment will likely be in around three months after you start therapy so they can evaluate your progress and response.

If they recommend dietary modifications or reflux medications, you’ll also be asked to follow up with an office visit too. If your voice responds to this type of treatment, then you won’t require any further follow-up. However, if your voice continues to be problematic, you may be asked to follow-up every six to 12 months so the doctor can monitor your voice.


Contact Houston ENT & Allergy  and the Houston Voice and Swallowing Center to Set Your Vocal Cord Nodules Appointment

Houston ENT Clinic has been delivering the highest quality care from birth to seniors using the most innovative, modern treatment protocol, along with offering informative patient education. We remain the leader in providing outstanding patient care whether you're seeking care for sinus problems or allergies, tubes or tonsils, balance or hearing issues, reconstructive facial surgery, and of course, vocal cord nodules.

Browse our website to gain access to information about our office locations, doctors, and about the services we offer. Our ENT doctors and staff members welcome you and your family to our clinic. Visit our website to request your appointment today.


Click the link below to learn more about the Houston Voice and Swallowing Center and it's physician Michael Underbrink, MD

Houston Voice and Swallowing Center


Michael P Underbrink, MD