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Suffolk Center for Speech

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#5 What are Vocal Nodules

Vocal Nodules are small nodes that develop on an individual’s vocal folds. In the beginning, the nodules are reddish or pinkish. As they develop over time, they appear white or grayish because they become fibrous and callous-like. Vocal nodules can appear unilateral (i.e., one side), but are typically bilateral (i.e., both sides) of the vocal folds. Nodule can develop over time as the result of prolonged vocal abusive behaviors. Vocal nodules cause an individual’s pitch to be lower, and a breathiness and hoarseness vocal quality. Vocal fatigue is also common. Vocal nodules are seen most frequently in children who scream and yell and in adults whose career or leisure activities involve vocally abusive practices (e.g., yelling at sport events, coaching). Singers are especially susceptible to vocal nodules. One way to reduce swelling of the nodules is vocal rest. However, if the vocal abusive behaviors don’t reduce, the nodules will grow larger and will rarely disappear. Two ways to treat vocal nodules is either voice therapy or surgery. Surgery involves removal of the nodules, whereas voice therapy will work on exercises of the voice and educating the patient on vocal hygiene and ways to reduce the vocal abusive behaviors.

Stemple, J.C, Roy, N. & Klaben, B.K. (2020). Clinical voice pathology: theory and management (6th ed.). San Diego, CA: Plural Publishing

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