Vocal Cord Nodules

What are the Symptoms of vocal cord nodules?

Although the symptoms of vocal cord nodules vary from person to person, vocal cord nodules should be suspected when one or more of the following symptoms are seen together or when hoarseness is experienced for more than two weeks:

• Voice changes such as hoarse, rough, tired, foggy, cracked or low-pitched (hoarse) voice,
• Restlessness in the throat, fatigue,
• Speech and Swallowing Difficulties,
• Inability to reach a high octave or complete loss of voice in singers.

A detailed examination by a specialist ear-nose-throat specialist should be performed to determine whether the symptoms indicate a vocal cord nodule.

In the examination of voice problems, the vocal cords are first observed. In parallel with technological advances in imaging tools, accurate results can now be obtained. The most commonly used imaging tools are Videolaryngostroboscopy (VLS), a stroboscopic imaging system that can acquire 30 frames per second, and High Speed Digital Visualization (HSDV), which can acquire 2000 frames per second. While VLS is mostly used clinically, HSDV is more commonly used in research laboratories due to its high cost and the inability to use flexible endoscopes. The observations made by the specialist are supported by objective sound analysis to identify the problem and decide on the appropriate treatment.

Nodules caused by medical problems such as reflux, sinusitis, allergies, enlarged thyroid gland are primarily treated with medication (medical treatment). In the treatment of vocal cord nodules that are not caused by medical problems, voice therapy or surgical intervention is used:

Voice Therapy: It is a therapy applied to acquire the necessary habits to use the voice at the correct intensity and height (pitch) and to prevent excessive pressure on the vocal cords. In voice therapy, the patient is firstly informed and educated about respiratory and articulatory organs, voice formation, protection of the vocal mechanism and hygiene. Afterwards, exercises for breathing and voice use are performed. It is applied in approximately 8-10 sessions over a period of 1-2 months.

Vocal Cord Nodule Surgery: Vocal cord nodules that do not improve despite the applied voice therapy and vocal cord rest are removed by surgical intervention. This intervention is called Vocal Cord Nodule Surgery.

How is Vocal Cord Nodule Surgery Performed?

After the diagnosis of vocal cord nodules is made, surgical intervention is decided if voice rest, medication and voice therapy methods do not yield results. Generally, endoscopic techniques such as Laser Surgery or Phonomicrosurgery, Microlaryngoscopy, which do not involve any excision (cutting out) are used:

Phonomic microsurgery / microlaryngoscopy: In cases where the vocal cord formation is large or in a hard-to-reach area, it is a surgical intervention to cut out the nodule. It is performed under general anesthesia. With the help of a laryngoscope and other endoscopic instruments that provide magnified high quality images, the vocal cords are accessed through the mouth and the nodule is cut out without damaging the surrounding healthy tissue. The operation takes 30-60 minutes on average. Since there is no need for stitches, the patient is discharged on the same day. Eating and drinking activities are not restricted, but whispering or speaking in a normal voice is not allowed for a week, voice rest is applied. There may be mild sore throat and difficulty in swallowing for a maximum of one day. In case of numbness in the tongue and loss of taste due to compression of the tongue during the operation, these complaints will resolve spontaneously within a few weeks.

Since the reason for the formation of vocal cord nodules is the misuse of the voice, the formation of nodules may recur if the voice is used incorrectly again after surgery. For this reason, it is absolutely necessary to receive voice therapy after the vocal cords have healed in order to learn and practice the correct use of the voice.

Are there any risks of vocal cord nodule surgery?

Vocal cord nodule surgery is not an intervention that carries serious risks. If the recommendations and instructions specified by the doctor are not followed after the operation, voice loss, bleeding, permanent voice disorder due to vocal cord trauma, vocal cord paralysis may occur rarely.

If you are experiencing problems such as hoarseness, voice change, restlessness and pain in the throat for more than ten days, you can contact us using our contact information; you can be treated in our center, which is dedicated to the diagnosis and treatment of vocal cord disorders, uses tools and apparatus equipped with the latest technologies, prioritizes your special demands and needs, and get more detailed information about your disease.