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Nodules, a thickening of the middle of the vocal folds, always occur in pairs—one on each vocal fold—and are fairly similar in shape and size.
• Nodules usually form slowly over time, and are usually caused by excessive vocal demands, or improper speaking or singing techniques.
• Symptoms include breathiness, a raspy voice, decreased loudness, and vocal fatigue. Nodules can also cause irregular vocal fold vibration, resulting in hoarseness and pitch breaks.
• Nodules are diagnosed by their appearance, and the treatment is usually a course of voice therapy. Infrequently, voice surgery is required if the voice therapy does not provide adequate symptom relief.
• The prognosis for nodules is excellent. In fact, 99% of the time, they will go away within two months with conservative management such as decreasing trauma or undergoing voice therapy.
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