What Are Vocal Nodules?

A laryngeal electromyography (EMG) helps our voice doctors evaluate voice muscles

Most singers dread this term and non-singers aren’t too fond of it either. However, we can think about vocal nodules as your body’s response to too much work placed on the vocal folds. One thing to note is that nodules tend to come in pairs, so benign vocal nodules are often on both sides.

There is an area in the middle of the vocal cords called the striking zone and this is where nodules tend to begin and form. In order to produce sound with your voice, the vocal cords vibrate many times per second. The higher the frequency of the pitch, the more times per second there is a vibratory cycle. This is why most people notice problems with their high voice or upper register when vocal problems begin. We often refer to this as ‘phonotrauma’ which means that producing voice (or phonation) has resulted in some trauma to the vocal cords.

For many patients, the process can be reversed. With voice therapy, a patient learns to better distribute the energy of all that vibration and not have it only concentrated in the striking zone. We usually start with voice therapy. Sometimes we add IV glutathione, and in some cases after therapy, surgery is required to remove the vocal nodules, but we try to keep this a rare event.