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Vocal Cord Nodules

Vocal Cord Nodules

The vocal cords (vocal cords - plica vocalis), also known as vocal folds, are a structure in the larynx cavity consisting of two ligamentous taut mucous membranes extending horizontally from front to back in a cartilaginous structure, which vibrate in different patterns to create sound.

The surfaces of the vocal cords are flat and when they close, their free surfaces meet, resulting in a complete closure.

Vocal Cord Nodules

The size of the vocal cords determines the pitch, i.e. the loudness of the voice, and they are shorter and thinner in women and children. This is why women and children have higher-pitched and thinner voices.

Voice is the most important communication tool that must be carefully protected against distortion and injury. Because the quality of the sound is related to the healthy and synchronized movement of the vocal cords. Excessive and abusive (forced) use of the voice, which causes excessive friction during the collision of the vocal cords against each other, leads to benign (benign) tissue deterioration (lesions), irritation and inflammation on the vocal cords that do not cause cancer over time. The vocal cords vibrate 100-150 times per second in men, 200-250 times per second in women and 400 times per second in infants. Therefore, the vocal cords are the tissue of the body that is exposed to the most wear and tear.

Vocal Cord Nodules are benign tissue degenerations that usually occur in the middle and front part of the free surface where the vocal cords come into contact with each other as a result of prolonged use of the voice at the wrong intensity and height (pitch) or excessive use of the voice. The microscopic appearance of vocal cord nodules gives them a callus-like appearance and they are sometimes associated with abnormal blood vessels. Since vocal cord nodules are usually formed by both vocal cords hitting each other, there are usually two of them and they are located opposite each other on both cords. They are also called Singer's Nodule or Singer's Node.

Factors such as intense smoking, reflux problems, working in extremely noisy environments that require speaking loudly, chronic alcohol use, sinusitis, allergies, thyroid gland enlargement, side effects of medication facilitate the formation of vocal cord nodules.

It is more likely to occur in voice artists, teachers, announcers and call center workers who are professional voice users, or in people who talk a lot due to their personality and living environment. Although it is seen in men, women and children, it is more common in women between the ages of 20 and 50 and in children who have a habit of shouting due to their larynx structure.

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.


Vocal Cord Nodules Information About

6-8 Seans
How Many Sessions Are Performed 6-8 Seans
40 Minutes
Processing Time 40 Minutes
5 Days Later
When to Return to Work 5 Days Later
General Anesthesia
Anesthesia General Anesthesia
Everyone's body structure is different. Therefore, everyone's treatment process, planning and results also differ. The information given about the procedure is average values. Please contact us for detailed information. communication get along.

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