A HOARSE VOICE OR VOCAL NODULES?

“My child contracted a nasty cough which developed into laryngitis according to our family doctor. It’s now been several weeks and the laryngitis has resolved but my child still has a hoarse voice. Should I be worried? Could they have developed vocal nodules?”

Vocal nodules are a condition that have gained some attention in the public consciousness due to high profile singers including Justin Timberlake, Adele, Rod Stewart and Julie Andrews, all having received well publicised treatment for the condition.

What Causes A Hoarse Voice?

A hoarse voice is a husky, strained or raspy sound. The most common cause of hoarseness is acute laryngitis (inflammation of the vocal cords)². This is often caused by an upper respiratory tract infection, such as cough, colds and sore throats.

What Are Vocal Nodules?

ASHA defines vocal cord nodules as benign (ie non cancerous) growths on the vocal cords ³. These growths can develop into harder, callous-like growths called nodules.

The British Voice Association points out that, unlike a hoarse voice, vocal nodules will develop as a result of trauma to the vocal cords ⁴. This is usually a direct consequence of vocal abuse that can be categorised as ‘voice misuse’ or ‘voice overuse’ .

So What Is Voice Misuse?

Activities associated with “voice misuse” can include speaking with tense muscles or at an abnormally high or low pitch. Some behaviours associated with “voice overuse” include chronic throat clearing, excessive coughing, inhaling irritants, smoking, screaming, yelling. A surprising fact is that harsh whispering puts added strain on the vocal cords, because you are squeezing the vocal cords tightly together when you whisper (Tip: Just speak softly!)

Is My Child At Risk Of Developing Vocal Nodules?

Well, the answer to this question lies in the root cause of your child’s hoarse voice. For example, if your child has experienced acute laryngitis following an upper respiratory tract infection (most likely a virus) then the likelihood of them developing vocal nodules is low.

Alternatively, if your child has been frequently screaming or yelling (parents of adolescents may identify with this) or engaging in more extreme behaviours such as inhaling irritants and smoking (which can often result in regular throat clearing and coughing) then they may be at a greater risk of developing vocal nodules.

Parents, carers, and teachers may be concerned about hoarseness leading to vocal nodules. However, “disorders of vocal abuse and misuse are the most prevalent and preventable of the types of voice disorders” ⁵. As such, intervening early to achieve a healthy and beautiful voice is vital. Check out our voice care tips here

References

1. Boone, D.R., McFarlane, S.C., Von Berg, S.L., Zraick, R. I (2014). The Voice and Voice Therapy, USA: Pearson Education
2. Doerr, S. (2016, June 10). Hoarseness [Article]. Retrieved from http://www.medicinenet.com/hoarseness/article.htm
3. Vocal Cord Nodules and Polyps [Web Page]. (n.d.). Retrived from http://www.asha.org/public/speech/disorders/NodulesPolyps/
4. Harris, S. (n.d.). Vocal Nodules [Web Page] Retrieved from http://www.britishvoiceassociation.org.uk/voicecare_vocal-nodules.htm
5. Vocal Abuse [Web Page]. (n.d.). Retrieved from http://www.timetohear.com/vocal-abuse/

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