Vocal cord nodules are also known as “calluses of the vocal fold.” They appear on both sides of the vocal cords, typically at the midpoint, and directly face each other. Like other calluses, these lesions often diminish or disappear when overuse of the area is stopped.

 

Nodules are caused when the vocal fold tissue forms hard callouses in response to repeated abuse. They are the most common lesions on the vocal folds. They occur on both vocal folds, are symmetric and can vary in size. Nodules can be chronic or acute, and can cause varied changes in the voice including roughness, tension, harshness breathiness and pain. Dysphonic vocal quality occurs because the nodules touch when you bring your vocal folds together to make sound and air escapes from above and below the nodules. This is called diplophonia, or a two-toned sound. Nodules result in an hourglass closure of the vocal folds. They can occur in children and adults and are a result of inappropriate vocal behaviors, excess talking, untrained singing or shouting and screaming often. Nodules usually can be remediated with voice therapy alone. When treatment does not improve, a surgical consultation is usually the next step. It is important to know that voice therapy can be a useful tool in treating these types of lesions because they are like callouses on the vocal folds. With a reduction in poor vocal habits, the callouses will lessen or disappear altogether.