An Introduction to Vocal Fold Nodules

Vocal fold nodules are benign and are often located at the midpoint of the membranous vocal fold (Rosen et al., 2000). They typically occur bilaterally and are correlated with epithelial changes and basement membrane fibrosis (Elsaeed et al., 2023; Nunes et al., 2013).

Nodules are often caused by chronic vocal abuse or misuse - trauma causes localized edema or submucosal hemorrhage on the vocal fold (Akif et al., 2004). The midpoint of the vocal fold is the point of maximal amplitude during the mucosal wave, therefore, it is subject to the most phono traumatic force (Akif et al., 2004).

Individuals whose work involves using their voice frequently, are at a higher risk for the development of vocal nodules (NIH, 2006).

For some individuals, voice therapy alone may be successful in treating vocal fold nodules (Naqvi & Gupta, 2023). Treatment recommendations may also include vocal rest, steam inhalation, vocal fold steroid injection (VFSI), and in certain cases surgical removal may be recommended (Elsaeed et al., 2023; NIH, 2006).