Vocal Fold Nodules and Polyps

What Are Vocal Fold 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 benign growths that form on the vocal folds. They are 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 callus. These nodules can get larger and stiffer if vocal misuse 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.

What Are Signs of Vocal Fold Nodules and Polyps?

Nodules and polyps cause similar symptoms. These include:

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

What Are 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 for many reasons, including:

• allergies
• drinking caffeine and alcohol, which dries out the throat and vocal folds
• overusing your voice (for example coaching, cheerleading, or talking loudly)
• singing
• smoking
• tense muscles

What Does Testing for Vocal Nodules and Polyps Look Like?

You should see a doctor if your voice has been hoarse for more than 2 to 3 weeks. You may also want to see a specialist called an otolaryngologist (also known as an ENT).

The SLP and/or ENT will listen to how your voice sounds. They may ask you to try to change your pitch and talk louder and softer. They may 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 or through your nose and into your throat. A flashing light, called a stroboscope, lets the team watch your vocal folds move.

What Does Treatment for Vocal Fold Nodules and Polyps Look Like?

Treatment depends on what caused the nodules or polyps, how big they are, and what problems they are causing. 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, such as reflux, allergies, or thyroid problems, 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 misuse 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 an SLP or audiologist near you, visit ProFind.

Other Resources

Inclusion on this list does not imply endorsement.

• Academy of Otolaryngology–Head and Neck Surgery
• View video examples of vocal nodules and polyps