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Vocal nodules occur due to overtaxing and voice abuse. They are also called Singer’s or Screamer’s nodules.

  • Age: Usually occur after puberty.
  • Sex: More common in females.
  • Occupation: Seen in untrained singers, teachers, hawkers, housewives and others who require regular loud talking.
  • Causes:
    • Vocal abuse– Screaming, shouting, continuous loud talking, forceful throat clearing etc. This is seen in untrained singers, teachers, hawkers etc.
    • Vocal misuse– This means talking in inappropriate pitch and loudness.
Pathology of Vocal Nodules:
  • Vocal nodules usually occur on both cords over a period of time, commonly at the junction of anterior and middle one third of the vocal cords. In children and adolescents, the misuse of voice leads to spindle shaped thickening at the edges of the vocal cords. In adults, the swellings are more localized forming vocal nodules. The epithelium over the edges of the vocal cords undergoes hyperkeratosis resulting in disturbed mucosal waves.
Clinical features:
  • Hoarseness of voice as the nodules interfere with normal vibrations of vocal cords.
  • Vocal fatigue.
  • Inability to sing too high or low tones.
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