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What Is a Vocal Nodule?

Reviewed by Dan Brennan, MD on April 25, 2021

Vocal nodules are growths or bumps that form on your vocal cords. These growths are not cancerous. They’re more like calluses that form on your vocal cords. Vocal nodules can make your voice crack or cut out when you’re talking. They can also make you sound raspy or hoarse. This happens because the nodules keep your vocal cords from vibrating properly. 

Your vocal cords are responsible for helping you talk, sing, yell, and make noise. Vocal nodules may also be called singer’s or screamer’s nodules. This is because they are formed by excessive strain on your vocal cords. 

What to Know About a Vocal Nodule?

When you talk, sing, or yell, you use your vocal cords. Your vocal cords help you make noise through the cords' vibrations. Vocal nodules form on your vocal cords where the tension and vibration are heaviest. 

Your vocal cords are two folds made of membrane tissue. They are located in the middle of your larynx. When you sing or talk, your vocal cords move close together and use the air that moves through them to vibrate and make a sound. This is also known as your voice box.  

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The nodules that form are not cancerous, but they can swell up and harden. The strain you put on your vocal cords by talking too loud or singing strenuously causes the folds in your vocal cords to swell. The longer your nodules go untreated, the larger they become. 

Vocal nodules are most common in young women and pre-adolescent boys. This may be due to the shape of their larynx. These nodules are also found in professional and amateur musical theater singers. There are some hypotheses that this occurrence happens because of the specific style of singing in musical theater.

Causes of a Vocal Nodule

Vocal nodules are most prevalent in people who use their voice a lot. These people may be teachers, lawyers, singers, or public speakers. Anyone who talks excessively could have a vocal nodule. 

Anyone who puts a lot of strain on their vocal cords is at risk for developing a vocal nodule. Breathing excessively into your chest rather than your belly could cause a vocal nodule. This type of breathing puts stress on your vocal cords. Bad posture can also play a factor. 

Other causes of vocal nodules include: 

  • Constant coughing
  • Acid reflux or GERD
  • Allergies
  • Speaking at a loud volume

You can harm your voice and develop vocal nodules because of smoking, allergies, singing, being a loud talker, and drinking caffeine. 

Signs and Symptoms of a Vocal Nodule

It can be difficult to know if you have a vocal nodule. They’re often painless and cause hoarseness. Vocal nodules can also make your voice cut in and out when you’re talking. 

There are other signs and symptoms to look for to know if you have a vocal nodule. They include:

  • "Rough or scratchy" voice
  • A harsh-sounding voice
  • Pain that shoots from ear to ear
  • Feel like you have a lump in your throat
  • Pain in your neck
  • Inability to change your pitch
  • Tiredness in your voice and body

If you have these symptoms and use your voice a lot, you should consult with your doctor. They will be able to determine the right treatment for you. This will also help you keep your vocal cords healthy in the long term.

Treatment

Your doctor will first determine that you have a vocal nodule. They’ll do this by looking at your vocal cords with a mirror or viewing tube. In some cases, your doctor may require a biopsy. If they need a biopsy, they’ll take a small piece of tissue to examine and determine the growth is not cancerous. 

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Once your doctor has diagnosed you with a vocal nodule, they may recommend learning vocal hygiene and voice therapy. Vocal hygiene means taking care of your vocal cords and not straining them. This includes:

  • Avoiding yelling or screaming
  • Drinking a lot of water
  • Maintaining a healthy diet
  • Managing reflux and allergy symptoms. These two conditions can cause your vocal folds to swell and create nodules.  

Voice therapy is an important part of treating nodules. The purpose of this therapy is to help you know how you use your voice too harshly. Voice therapy is meant to help you learn ways to keep from straining your voice again in the future.

WebMD Medical Reference

Sources

SOURCES:

American Speech-Language-Hearing Association: “Vocal Cord Nodules and Polyps.”

Children’s Hospital of Philadelphia: “Vocal Cord Nodules Causes, Symptoms and Treatment.”

Duke Health: “Vocal Cord Nodules, Cysts, and Polyps.”

Harvard Health Publishing: “Vocal Cord Disorders.”

Institute for Quality and Efficiency in Health Care: “Vocal nodules: Overview.”

John Hopkins Medicine: “Vocal Cord Disorders.”

MERCK MANUAL: “Vocal Cord Polyps, Nodules, Granulomas, Papillomas.”

UNIVERSITY OF MIAMI HEALTH SYSTEM: “Vocal Fold Nodules, Cysts, and Polyps.”

Weill Cornell Medicine: “Nodules.”

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