The formation of nodules on the vocal cords usually occurs due to poor and prolonged use of the voice. At the points where the vocal cords hit each other during vibration, inflammatory processes begin as a result of chronic trauma
What Causes Nodules on the Vocal Cords?
The formation of nodules on the vocal cords usually occurs due to poor and prolonged use of the voice. At the points where the vocal cords hit each other during vibration, inflammatory processes begin as a result of chronic trauma. This process continues with fluid accumulation in the tissue and changes in the properties of the cells over time. With continued misuse of the voice, these changes can become permanent. Especially in people who use their voice intensively for their profession, such as vocal artists, teachers and politicians, nodules on the vocal cords are more common.
What are the Symptoms of Vocal Nodules?
The most common symptom of vocal cord nodules is hoarseness. This can persist for a long time, worsen over time or increase after overuse of the voice. A rough and forked voice is also a symptom of a nodule. Symptoms of nodules on the vocal cords usually occur after heavy use of the voice and may become more pronounced over time.
What are the Types of Vocal Cord Nodules?
Vocal cord nodules are usually bilateral and are called ‘kissing nodules’ because they are mutual. Unilateral nodules are also present. In addition, vocal cord polyps are the next most common lesion after nodules and are usually unilateral. Unlike nodules, vocal cord polyps can be differentiated from nodules by the areas of vascularization above them and can often reach larger sizes.
Are Vocal Nodules More Common in Women?
Vocal cord nodules can occur at any age and in both sexes, but are more common in certain groups. Generally, they are more common in adults due to intensive voice use. It is less common in men than in women, but this may be related to occupational voice use. It can also occur in children, but tends to decrease after puberty.
What causes vocal cord nodules?
The physiological causes of nodule formation on the vocal cords are based on chronic overuse and misuse of the vocal cords. Constant loud and forceful use of the vocal cords leads to microtraumas in the vocal cords. This leads to hardening of the soft tissue in the vocal cords and nodule formation. The structure of the vocal cords and the way they are used are important factors affecting the risk of nodule formation.
The reason why nodules are more common in women and children is that the frequency of the vocal cords is higher in these groups. As the voice becomes thinner, the vocal cords vibrate more frequently and the vocal cords hit each other more often. This facilitates the formation of nodules.
How is Vocal Cord Nodule Diagnosed?
The diagnosis of a vocal cord nodule is based on a thorough clinical evaluation and detailed examination of the vocal cords. This process involves taking an anamnesis including the patient’s voice complaints, voice use habits and voice-related occupational requirements. Patients with hoarseness or other voice problems are usually evaluated by an ENT specialist. The diagnostic process uses a procedure called laryngoscopy. In this procedure, the vocal cords are directly observed using a camera or mirror. Laryngoscopy is vital to determine the movement of the vocal cords, their surface structure and any abnormalities, especially the presence of nodules. In advanced cases, a more detailed examination method called laryngovideostroboscopy can be used. This method allows observation of the vibration and movement of the vocal cords at a slowed down rate, which allows for a more detailed assessment.
How is a Vocal Cord Examination Performed?
A vocal cord examination involves a series of procedures used to assess the structure and function of the vocal cords. This examination usually begins with laryngoscopy. Laryngoscopy is a procedure that allows direct observation of the vocal cords and is usually performed using a flexible fiberoptic laryngoscope or a rigid endoscope. As the patient speaks or makes sounds such as “ee” during the examination, the doctor can observe the movement and symmetry of the vocal cords and any abnormalities. Laryngovideostroboscopy is used to examine the movements of the vocal cords in more detail. This method allows observation of the vibration and movement of the vocal cords at a slowed down speed, which allows abnormalities such as nodules, polyps or other lesions to be more clearly detected. These examinations are critical in the diagnosis of vocal cord nodules and help determine the most appropriate treatment plan for the patient.
Are Vocal Cord Nodules and Thyroid Nodules the Same?
Vocal cord nodules can sometimes be confused with thyroid nodules. While vocal cord nodules are related to the voice and are on the inside of our throat, thyroid glands and thyroid nodules are just under our skin. And the two are completely different structures. These two conditions affect different structures and cause different symptoms. Vocal cord nodules occur in the vocal cords, while thyroid nodules occur in the thyroid gland. While vocal cord nodules cause voice-related symptoms such as hoarseness, thyroid nodules usually cause different symptoms such as swelling or discomfort in the neck.
While thyroid nodules can be diagnosed with ultrasound, vocal cord nodules can only be diagnosed with the help of endoscopes with an oral camera.
Things to Consider in the Diagnosis of Vocal Nodules
Patients diagnosed with vocal cord nodules may sometimes have other underlying diseases. Therefore, a detailed and comprehensive vocal cord examination is important. Imaging methods such as laryngoscopy provide a detailed examination of the vocal cords and help to make the correct diagnosis. It is also important to evaluate patients diagnosed with vocal cord nodules for other conditions that may cause hoarseness.
How is a Vocal Nodule Treated?
Treatment of a vocal cord nodule varies depending on the size of the nodule, the severity of the symptoms and the patient’s voice use needs. The first step is usually vocal rest and improved vocal hygiene. This helps to reduce the stress placed on the vocal cords and helps the nodules to heal naturally. If the nodules are caused by professional use of the voice, it may be necessary to reduce or change professional voice use. Avoiding habits that can damage the vocal cords, such as smoking and alcohol consumption, is also part of the treatment. Medication can help relieve symptoms, especially if there are underlying causes such as reflux or allergies.
Is Voice Therapy Effective for Vocal Cord Nodules?
Voice therapy plays an important role in the treatment of vocal cord nodules and in many cases is sufficient to treat nodules without the need for surgery. Voice therapy teaches the patient to use their voice in a more effective and healthy way. This reduces the pressure on the vocal cords and can help heal existing nodules. Voice therapy includes training in the correct use of the voice, breathing techniques, correct projection of the voice and vocal hygiene. Patients work with a program customized to their individual needs by voice therapists.
Treatment Methods other than Voice Therapy for vocal cord nodules
In patients who do not respond to voice therapy, surgery may be recommended, especially if the nodules are large and persistent. Surgical treatment is usually a procedure called phonomicrosurgery, which aims to carefully remove nodules from the vocal cords. This procedure is performed under general anesthesia and uses microscopic instruments to precisely remove the nodules from the vocal cords. After surgery, voice therapy is usually continued to improve the voice and restore optimal function.
Can Surgery be Performed for Vocal Cord Nodules?
Yes, vocal cord nodules can be operated on, and in some cases this may be the most effective treatment. This surgical procedure, called phonomicrosurgery, aims to carefully remove nodules on the vocal cords with microscopic instruments. The surgery is performed under general anesthesia and requires a high level of precision to remove the nodules without damaging the vocal cords. In the post-operative period, a period of voice rest followed by voice therapy is usually recommended to allow the voice to recover. Surgery is a preferred option, especially for large nodules or in cases that do not respond to voice therapy.
What to do if there is a nodule on the vocal cords?
When nodules are detected on the vocal cords, it is important to be aware of the correct use of the voice and vocal hygiene. Voice therapy and following the doctor’s recommendations can be effective in treating nodules. Voice therapy provides training in the correct use of the voice and helps to change habits that damage the vocal cords. In addition, once a vocal cord nodule has been diagnosed, regular medical check-ups and follow-up are important.
What happens if a vocal cord nodule is not treated?
If vocal cord nodules are left untreated, persistent hoarseness and permanent deterioration in voice quality can occur. This can cause serious problems, especially for people who use their voice for their profession (e.g. voice artists, teachers). In the long term, vocal cord nodules can cause permanent damage to the vocal cords and permanent impairment of the voice.
What to Do After Vocal Nodule Surgery?
In the postoperative period, it is important to be careful about the correct use of the voice and vocal hygiene. Voice therapy and other treatment guidelines recommended by the doctor should be followed. After surgery, the vocal cords should be given enough time to heal and overuse of the voice should be avoided. It is also important to avoid habits that can damage the vocal cords, such as smoking.
Vocal Cord Nodules and Occupations
Vocal cord nodules are particularly common in people who use their voices extensively for their profession. Professionals at risk include teachers, vocal artists, lawyers, politicians and television presenters. Awareness of vocal hygiene and regular voice therapy sessions can be effective in preventing vocal cord nodules.
Prevention of Vocal Cord Nodules
Vocal hygiene and correct voice use are essential for the prevention of vocal cord nodules. Avoiding talking, shouting or singing loudly for long periods of time is important to maintain the health of the vocal cords. It is also important to avoid habits that can damage the vocal cords, such as smoking and alcohol consumption. People who use their voice for their profession are advised to attend regular voice therapy sessions and take the necessary measures to protect their voice.
Conclusion
Vocal cord nodules are a common problem that develops due to misuse of the voice and causes symptoms such as hoarseness. Vocal hygiene and correct voice use are critical in the prevention and treatment of this problem. Vocal cord nodules are especially common in people who use their voice for their profession and can be managed with the right treatment. Voice therapy and, if necessary, surgical intervention are effective methods in the treatment of this condition. Vocal cord nodules should be taken seriously and treated early, otherwise they can lead to permanent voice problems.
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