More on Nodules

More on Nodules

Nodules are similar to callouses that might form on the fingers of guitar-players. Deposits of tissue build up as a protection to the tender layers beneath. The primary cause is frequent, intense oppositional movement of the vocal folds against each other, such as yelling or using the voice too much and/or too vigorously. They can also be caused by smoking, alcohol or caffeine consumption, chronic cough or allergies. The vocal folds vibrate during the normal speaking range at approximately 200 beats per second for females and 100 beats per second for males. When the voice is being used gently, a healthy voice can usually withstand this frequency, and even much greater ones when singing. Flexible vocal folds will vibrate as lips do during a “lip buzz.”  However, when the voice is squeezed too tightly and the intensity is too strong, the cords become strained and injury is initiated. Sometimes it takes years for the full extent of damage to occur. The harm may be so gradual at first, that no change in the voice is noted. But as the callous builds up, the vocal cords become stiffer and cannot vibrate freely. This causes a tighter squeeze so that the voice can come through, becoming a vicious cycle of abuse. If you notice hoarseness that lasts longer than 2-3 weeks, be sure and visit a vocologist and an otolaryngologist who specializes in voice, to take a picture of your vocal cords and see what might be causing the problem. If you can catch nodules while they are still soft, there’s a chance of avoiding surgery and making changes to heal and prevent further growths from occurring. 

Oh No, Nodules!

3/8/16

Oh No, Nodules!

Vocal fold nodules are a singer’s worst nightmare. In the past, when nodules were discovered on the vocal folds, the primary solution was to remove them. However, it was soon discovered that once removed, they often recurred in very little time. Nodules are formed due to excess stress on a particular area of the vocal folds, commonly called a form of vocal abuse. Removing the nodule does not cure the problem. Most people continue in the same vocal habits, leading to more nodules. Even well-trained singers can develop nodules if they use their voices excessively, sing too loudly or at the outer limits of their comfortable range too frequently. Singers are not the only ones who develop nodules. They can form as a result of errant speech patterns as well. A singer is taught to sing, but one rarely receives “speaking” lessons. Speaking patterns and mannerisms are typically learned from our major caregiver as a child, and carried through life, for better or worse. Many people are surprised to learn the importance of adequate breath support, forward focus, ease of phonation, release of tension and easy onset in maintaining a healthy speaking voice. In today’s society, a low-pitched, gravelly voice is frequently the norm for many, including adolescents. Most are not even aware of the fact that they are harming their voices by the way they speak. Awareness is the first step. Fortunately, for someone diagnosed with nodules, surgery is rarely the only option, nor is it the first one considered. Vocal rest is usually recommended along with a course of voice therapy from a skilled speech-language pathologist who specializes in voice. The voice therapist will provide compensatory strategies, gentle exercises and instruction in ways to allow the breath to support the sound and produce “easy” speaking, to reduce the load on the voice. This course is usually a radical change in self-concept for the participant. Many argue that the new speaking method just “isn’t me,” expressing concerns that it will change their personality if they switch to a gentler mode of speaking. While it is true that the voice will hopefully change to something healthier, the personality need not necessarily follow suit. One can maintain personality traits without using vocally damaging speech patterns to get points across during conversation. You only have one chance at a healthy voice. Treat it gently. Avoid excessive or loud speaking, yelling, vocal fry, grunting, singing outside of your range and in general, anything that tires your voice excessively. It is much easier to prevent nodules than to treat them once they form. Take preventative action and develop healthy speaking patterns to reduce the possibility of nodules in your future.