Vocal cord nodules and polyps
Nodules on the vocal cord result from hypertrophy of fibrous tissue and form at the point where the cords come together forcibly. Vocal cord polyps are swellings on the true vocal cord caused by edema in the lamina propria of the mucous membrane. Nodules and polyps have good prognoses, unless continued voice abuse causes recurrence, with subsequent scarring and permanent hoarseness.
Vocal cord nodules and polyps usually result from voice abuse, especially in the presence of infection. Voice abuse results from speaking consistently at the wrong pitch or for a long duration, and using too loud a voice. Many vocal abusers combine all three practices. Consequently, vocal cord nodules and polyps are seen most commonly in teachers, singers, and sports fans, and in energetic children (ages 8 to 12) who continually shout while playing. Polyps are common in adults who smoke, live in dry climates, or have allergies.
How nodules cause hoarseness
Vocal cord nodules cause hoarseness by inhibiting proper closure of the vocal cords during phonation. The most common site of vocal cord nodules is the point of maximal vibration and impact (junction of the anterior one-third and the posterior two-thirds of the vocal cord).