DOI: 10.1097/MOO.0b013e3283324531

,  

,  

PMID: 19907222

Issn Print: 1068-9508

Publication Date: 2009/12/01


Print

Editorial comment

Peter C Belafsky

    loading  Checking for direct PDF access through Ovid

Excerpt

Vocal fold nodules (VFNs) are bilateral, symmetric, mucosal thickenings on the mid-portion of the musculomembranous vocal fold. They are one of the most frequent abnormalities encountered by the laryngeal surgeon and a thorough understanding of the epidemiology, pathogenesis, and treatment of VFNs is warranted.
The effects of VFNs range from a serendipitous finding on laryngoscopy to a career ending occupational injury for an elite vocal performer. Because of their association with vocal overuse, misuse, and abuse, the time-honored first-line treatment for nodules has been and will continue to be voice therapy. If therapy fails, we recommend more therapy. Only when a consummate attempt at speech therapy is unsuccessful do we consider surgical options. The justification for a judicious approach to surgery for VFNs is that even a modest scar on the most delicate portion of the vocal fold can cause significantly more dysphonia than the nodules themselves. Never is the principle of primum non nocere more appropriate than when considering surgery for VFNs. It is for this reason that numerous clinicians have introduced minimally invasive treatment options for VFNs. These approaches include radiofrequency ablation, laser resection, and botulinum toxin injection. To prevent recurrence, it is customary to recommend speech therapy to accompany surgical intervention. In order to update the voice clinician and surgeon on these contemporary approaches, we have dedicated this issue of Current Opinion to the diagnosis, treatment, and prevention of VFNs.
    loading  Loading Related Articles