Vocal cord nodules

What are vocal cord nodules

Vocal cord nodules (also known as singer’s nodules or teacher’s nodules) are small, benign (non-cancerous) growths that form on both vocal cords. They are caused by repeated strain or overuse of the voice, which leads to swelling and thickening of the vocal cord tissue.

What causes them

Nodules are usually caused by chronic vocal strain, including:

• Speaking or singing loudly for long periods.
• Shouting or screaming.
• Poor voice technique.
• Frequent throat clearing or coughing.
• Smoke and other irritants can worsen voice symptoms, although repeated vocal strain is the main cause of nodules.
• Reflux may coexist and irritate the throat; it should not automatically be assumed to be the cause.

Symptoms

• Hoarseness.
• Raspy or breathy voice.
• Voice fatigue or weakness.
• Reduced vocal range (especially for high notes).
• Throat discomfort or tightness.
• Frequent need to clear the throat.

Diagnosis

Diagnosis is usually made by an ENT specialist using a laryngoscope – a small camera that allows them to look directly at your vocal cords while you speak. Speech and language therapists may also be involved in assessment.

Treatment

Most nodules improve with voice therapy, not surgery. Treatment includes:

Speech and language therapy

• Teaching proper voice use.
• Reducing strain and tension.
• Improving breathing and posture.
• Addressing habits like throat clearing.

Medical treatment

• Managing reflux, allergies, or other contributing conditions.

Surgery

• Reserved for persistent nodules that don’t improve with therapy.

Self-care tips

• Rest your voice if it feels tired.
• Avoid shouting, whispering, or straining the voice.
• Stay hydrated.
• Avoid smoking and environmental irritants.
• Treat reflux or allergies if present.
• Warm up your voice before heavy use (especially singers).

When to seek help

Arrange a GP review if hoarseness lasts more than 3 weeks, keeps returning or affects your work or daily life. Seek advice sooner if it is worsening or you have a neck lump, pain on swallowing, coughing up blood or unexplained weight loss.

Call 999 if you have severe breathing difficulty or noisy breathing with distress.