vocal nodule
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communication disorders
communication disorders
communication disorders
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vocal nodule
Vocal nodules are small nodes that develop on vocal folds and protrude from the surrounding cells. In the beginning, the nodules are red or pink. Later, they appear white or gray because they become fibrous. Vocal nodules can be unilateral. Typically, though, they are bilateral. The two nodules sit opposite each other on the two folds. The nodules frequently appear at the junction of anterior and middle-third portion of the vocal folds. They are well defined in the beginning stages but become more diffuse later because of the inflammation of the surrounding tissue. Vocal nodules are seen most frequently in children who scream and yell on playgrounds and in adults who yell out their enthusiasm for their favorite sports teams and boo the opponents. The nodules develop because of the frequent friction between the two folds. Such friction is necessary to produce the screams of joy and shouts of contempt. Any profession that requires a constant and intense use of voice poses a risk for vocal nodules. Teachers, preachers, and signers especially are susceptible to vocal nodules. In fact, the vocal nodules also are known as singer's nodes. The vocal nodules increase the mass of the folds. Consequently, the folds vibrate at a slower rate. The slower vibration results in lower pitch. Because the nodules make it difficult to close the folds firmly, air leaks during phonation, causing breathy voice. Hoarseness also is a common feature of vocal nodules. Voice therapy is preferable to surgical removal of vocal nodules. Surgery may permanently scar the vocal folds, affecting its efficiency. Some singer's careers have been cut short by surgery for the nodules. See for the story of a famous singer whose surgical removal of her vocal nodules negatively affected her singing career. Vocal rest and voice therapy usually clear the nodules, but prolonged abuse of the folds results in larger and more persistent nodules. Unless the person's abusive behaviors are changed, the nodules may not disappear. It is the responsibility of the speech-language pathologist to change the vocally abusive behaviors that have caused the nodules and the resulting voice problem. The techniques of voice therapy for vocally abusive clients are described.
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