Vocal cord nodules are bilaterally symmetrical benign white masses (nodules) that form at the midpoint of the vocal folds. Although diagnosis involves a physical examination of the head and neck, as well as perceptual voice measures, visualization of the vocal nodules via laryngeal endoscopy remains the primary diagnostic method.
Vocal fold nodules interfere with the vibratory characteristics of the vocal folds by increasing the mass of the vocal folds and changing the configuration of the vocal fold closure pattern. Due to these changes, the quality of the voice may be affected. Other common symptoms include vocal fatigue, soreness or pain lateral to the larynx, and reduced frequency and intensity range. Vocal hygiene practices include three components: regulating the quantity and quality of voice use, improving vocal fold hydration, and reducing behaviours that jeopardize vocal health. Treatment of vocal fold nodules usually involves behavioural intervention therapy administered by a speech–language pathologist. In severe cases, surgery to remove the lesions is recommended for best prognosis. In children, vocal fold nodules are more common in males; in adults, they are more common in females. Visualization is considered to be the main method of diagnosis as perceptual evaluation, which includes acoustic and aerodynamic measures, alone is insufficient. Laryngeal videostroboscopy, an imaging technique, is commonly used to view the vocal folds: this procedure can be performed nasally or orally. They are diagnosed based on the presence of perceptual features not explicable by other causes. Furthermore, recommendations for voice professionals include warm-up and cool-down exercises for the voice to reduce strain. Consumption of caffeine in large quantities is dehydrating and is therefore implicated in an increased risk of vocal fold nodules. The avoidance of damaging vocal behaviours may prevent the formation of nodules. Tobacco, alcohol, certain medications, and recreational drugs have also been implicated in pathologies of the vocal folds. Because of general risks of surgery (e.g. scar formation, or those posed by general anesthesia While behavioural treatments methods vary greatly, they are generally effective at improving vocal quality and decreasing size of vocal fold nodules.), perceptually While the patient is subdued under general anesthesia, long thin scissors and scalpels or CO<sub>2</sub> surgical lasers might be used to remove the nodules. However, in adulthood, women are more likely to have nodules, and are especially likely if they have an outgoing personality or sing frequently.