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Voice and Resonance

Vocal Nodules

Vocal nodules:

  • are small, benign (not cancerous) bumps on the edges of the vocal cords
  • are usually on both sides of the vocal cords
  • are soft when they first start growing
  • become harder and more like corns or calluses over time
  • affect the normal contact and vibration of the vocal cords
  • change voice quality

How is my voice quality affected?

Your voice may become “breathy”, tense, low pitched, and tend to sound rough or husky. This is because:

  • vocal nodules keep the vocal cords from closing properly so too much air escapes, causing the breathy voice
  • you have to use more effort to make a louder or clearer voice so your voice sounds harsh or tense (This may also make the problem worse.)
  • the extra mass of the nodules on the vocal cords can lower your speaking pitch

What causes vocal nodules?

Vocal nodules are usually caused by over using the vocal folds or using them with too much force. Nodules can develop quickly (e.g., yelling or cheering at a hockey game) or over time. Allergies, colds, infectious laryngitis, and using tobacco, alcohol, and other drugs can make them worse.

They often develop when people:

  • talk loudly, especially in noisy pl​aces
  • clear their throat or cough a lot
  • talk or sing a lot most days
  • shout and scream
  • do sound effects, like car or monster noises

What can be done about vocal nodules?

Voice therapy

The preferred treatment for vocal nodules is voice therapy. Nodules that formed from poor vocal habits can become smaller and go away over time if you change the way you use your voice.

A speech-language pathologist (SLP) can help you to learn:

  • how your vocal folds were hurt
  • not to do the things that caused your nodules or made them worse
  • to do things every day that are good for your voice
  • to use your breath to make your speech louder
  • to use the correct voice pitch and loudness
  • exercises to do at home
  • how to apply the exercises to your speaking situations
  • when to use a microphone or voice amplifier

How long does it take?

You’ll likely see some improvement during the first 2 to 4 months. It will take more time, home practice, and motivation to form new habits and make permanent changes in your voice.

What about surgery?

Surgery is a last resort for vocal nodules, and seldom used as a treatment. This is because, although the nodules are taken off, they’ll still come back if you don’t change the vocal habits that caused them. Voice therapy is still recommended before and after surgery.​

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Where to go get help

For more information about how speech-language pathologists and audiologists can help, contact:

  • Your doctor, public health nurse, or other health provider
  • Your local health centre

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