Vocal Cord Nodules and Polyps

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Nodules and polyps are growths on your vocal folds. They can change the way your voice sounds. Speech-language pathologists, or SLPs, can help.

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About Vocal Nodules and Polyps

Your vocal folds are inside your larynx, or voice box. When you talk, air moves from your lungs through the vocal folds to your mouth. The vocal folds vibrate to produce sound. Anything that makes it harder for the vocal folds to vibrate can cause a voice problem.

Vocal fold nodules are growths that form on the vocal folds. They are benign, or not cancerous. When you use your voice the wrong way, your vocal folds may swell. Over time, the swollen spots can get harder, like a callous. These nodules can get larger and stiffer if your vocal abuse continues.

Polyps can be on one or both of the vocal folds. They may look like a swollen spot or bump, a blister, or a thin, long growth. Most polyps are bigger than nodules. You may hear them called polypoid degeneration or Reinke’s edema. It may be easiest to think of a nodule as a callous and a polyp as a blister.

Signs of Vocal Fold Nodules and Polyps

Nodules and polyps cause similar symptoms. These include:

  • hoarseness
  • breathiness
  • a "rough" voice
  • a "scratchy" voice
  • a harsh-sounding voice
  • shooting pain from ear to ear
  • feeling like you have a "lump in your throat"
  • neck pain
  • less ability to change your pitch
  • voice and body tiredness

Causes of Vocal Fold Nodules and Polyps

Most of the time, vocal abuse or misuse causes nodules. Long-term vocal abuse can cause polyps, too. But polyps may happen after just one instance of vocal abuse, like yelling at a concert. Smoking cigarettes for a long time, thyroid problems, and reflux may also cause polyps.

Vocal abuse can happen in many ways, including from:

  • allergies
  • smoking
  • tense muscles
  • singing
  • coaching
  • cheerleading
  • talking loudly
  • drinking caffeine and alcohol, which dries out the throat and vocal folds

Testing for Vocal Nodules and Polyps

You should see a doctor if your voice has been hoarse for more than 2 to 3 weeks. You may want to see an otolaryngologist, or ear, nose, and throat doctor, who knows about voice problems. An SLP can test how your voice sounds. You may also see a neurologist, allergist, or other doctor, if needed.

The team will listen to how your voice sounds. They will ask you to try to change your pitch and talk louder and softer. They will want to see how long you can keep your voice going before you lose your voice. They may look into your throat to see how your vocal folds move. They can see if there are nodules or polyps on your vocal folds. They do this by putting a long tube, called an endoscope, in your mouth. A flashing light, called a stroboscope, lets the team watch your vocal folds move.

Treatments for Vocal Fold Nodules and Polyps

Treatment depends on what caused the nodules or polyps, how big they are, and what problems you have. You can have surgery to remove the nodules or polyps. This is usually done only when they are large or have been there for a long time. Children do not usually have surgery.

You need to treat any medical causes of your voice problem. You may need to have your reflux, allergies, or thyroid problems treated before the nodules or polyps will go away. You may also need medical help to stop smoking or to control stress and tension.

You may see an SLP for voice therapy. The SLP can teach you how to take care of your voice, called vocal hygiene. You can learn about how you abuse your voice and what to do to stop. Treatment may also help you change how your voice sounds or teach you how to get enough breath to talk. The SLP can also help you find ways to relax and feel less stressed.

To find a speech-language pathologist near you, visit ProFind.

Other Resources

This list does not include every web site on this topic. ASHA does not endorse the information on these sites.

See ASHA information for professionals on the Practice Portal's Voice Disorders page.

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