Vocal Nodules: What some singers have, but no one wants!

By: Alexis Tolentino, Grace Vernon, and Lindsey Watkins

Many of your favorite celebrity singers, all the way from MTV to broadway, have one thing in common: vocal nodules. Beyonce, Adele, Mariah Carey, and more have all been afflicted at one point or another throughout their careers. But what are vocal nodules? And, can they be prevented? Vocal nodules occur due to inflammatory degeneration of the superficial lamina propria (the outermost layer of skin on the vocal cords) with associated irritation and swelling. They are essentially calluses on your vocal cords. This typically happens due to vocal abuse, like screaming, aggressively talking, untrained singing, and high voice use in general. Nodules can result in a voice change characterized by a rough, breathy, and hoarse quality. Heavy voice users such as singers, teachers, and public speakers are at the highest risk for developing nodules. However, it can happen to anyone! Vocal nodules are the most common type of voice pathology and approximately 2.29-16.9% of the general population may experience vocal nodules in their lifetime.

Thankfully, there are several ways that we can prevent damage to the vocal folds leading to development of vocal nodules that are fairly easy to implement. These measures can be broken into two categories: vocal hygiene, and avoidance of phonotraumatic (abusive) behaviors. Vocal hygiene involves taking care of the vocal folds through adequate hydration, avoidance of the inhalation of substances such as cigarette smoke, and avoidance of substances that are drying to the laryngeal mucosa such as alcohol and caffeine. Regarding phonotraumatic behaviors, one should avoiding yelling, excessive and aggressive talking, and vocal fry (voicing at the very lowest pitches). Incorporating voice rest (no voicing, not even whispering) when possible. It is also important to know that people tend to engage in some of these phonotraumatic behaviors in loud environments, such as at football games and concerts. In order to avoid an onset of vocal nodules, avoiding vocal overuse in these environments and performing excellent oral hygiene before, during, and after can help avoid developing vocal nodules.

If you or someone you know do develop vocal nodules, the good news is that they are typically not that serious. They are benign lesions, and often will go away with vocal rest, improved vocal hygiene, and voice therapy. Ear, nose, and throat (ENT) doctors and speech-language pathologists (SLP) work with patients with vocal nodules (and many other types of voice problems) to determine the best approach for management.


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