“Women’s vocal cords are generally more susceptible to developing nodules and other types of injuries”

The bone nodulealong with polyps, are the most common benign lesions that affect vocal cords. They frequently occur in voice professionals, such as teachers, singers, communicators and, in general, in anyone who uses the voice as a work tool or who has inadequate vocal habits.

Being localized thickenings in the lining of the free edge of the vocal cord, they are compared to calluses on the hands and also usually appear symmetrically, one on each vocal cord. We talk about the causes that cause them, methods to prevent them and the most effective treatments with singing teachers Esther Justel there Charles Campaignvocal consultants, heads of the Vokalo Academy and two of the first Spaniards to study with the prestigious Seth Riggs, creator of the Speech Level Singing vocal method, which has been used and is used by artists of the stature of Barbra Streisand, Ozzy Osbourne, Prince oh Madonna.

For the uninitiated, what exactly are vocal cord nodules and what causes them?These are callous-like lumps that can appear on the hands, and it’s more common for two to appear (one on each vocal cord) than just one. In the case of a normal voice, which does not have problems at the structural level, the nodules appear due to voice abuse, such as shouting a lot, using the voice a lot without maintaining adequate hydration or singing with an incorrect voice. . technical. Additionally, a voice that has a congenital structural problem can cause the person to use their voice incorrectly, which can lead to the appearance of nodules.

Suffering from gastroesophageal reflux can also promote the appearance of nodules, since stomach acid can reach the vocal cords and burn them, causing them to become inflamed and, therefore, poor use of the voice. Smoking, similarly, can produce a similar effect, as inhaled smoke is at high temperatures and goes directly to the lungs, passing first through the vocal cords, and can also burn them, causing the same problems. In any case, the cause is always the same: very intense repeated collisions between the vocal cords and, from the friction, the nodules appear.

Nodules are callus-like masses and it is more common for two to appear, one on each vocal cord

What are the most common symptoms that can alert us to the presence of nodules?Generally speaking, the nodules go through two phases: when they form, they are called soft nodules, and if the voice continues to be abused, little by little, they become hard nodules. Soft nodules can cause small changes in the sound of the voice, such as raspy, excessively airy sound, drops in pitch to speech, small “cocks”, especially in the high-pitched area. In some cases, they can cause mild discomfort, although this is not usual.

When advanced (hard nodules), symptoms are aggravated by coughing, voice fatigue, extremely raspy and/or airy voice, total or near total disappearance of high-pitched sounds, and internal pain in the laryngeal region. .or the neck.

In the advanced stage, symptoms are aggravated by coughing, voice fatigue and internal pain in the larynx or neck.

Are there specific tests to detect them? How does the specialist assess it?You can start suspecting yourself if you have several of the symptoms we mentioned earlier, although this is not conclusive as they may be caused by other reasons. The first thing we look at is how the person’s voice sounds when speaking. When we meet a new student, we always ask them about their goals and a bit about their background with voice, to find out where they come from. In this phase, we take the opportunity to listen to anything unusual that may indicate a type of injury, among others. If everything sounds good, we perform a specific diagnostic exercise to be able to highlight any technical shortcomings and, if there is any damage, the voice starts behaving in unusual ways.

When we start working on exercises, it starts to become more apparent if there is a problem, because they don’t work the way they do with a healthy voice. Sometimes it’s obvious, and other times you know it from experience. In any case, the existence of vocal nodules must always be confirmed by a doctor by means of an examination.

Carlos Campaña and Esther Justel de Vokalo

Esther Justel and Carlos Campana

  • Singing teachers and vocal consultants

Michael Jackson, Stevie Wonder, Whoopi Goldberg, Barbra Streisand, Cristian Castro, Tina Turner, Ozzy Osborne, Prince, Madonna… All have used or use the Speech Level Singing method to get to know and improve their voice with Seth Riggs, the creator of the vocal method.

Carlos Campaña y Esther Justel de Vokalo fueron los primeros españoles en estudiar con Seth Riggs y Greg Enríquez, su pupilo, certificándose oficiallymente en esta técnica –que permite cantar cualquier nota o emitir sonido, en cualquier estilo, sin esfuerzo y sonando natural– para enseñar in the same way.

These singing teachers claim to be “the Seth Riggs” of our country, and also vocal consultants for teachers, actors, journalists and, in general, anyone who uses their voice as a tool, avoiding or improving the problems of vocal cords, helping to develop a healthy voice.

Is it true that they are more common in women?Yes, in general women’s vocal cords have less muscle mass than men’s and tend to be more susceptible to developing nodules and other types of injuries. But only if they abuse their voice. If they learn to use it correctly, there is no danger.

The first thing to know is whether they are soft or hard nodules. If they are hard nodules, surgery is usually recommended.

If we are diagnosed with nodules, what are the usual treatments and expert professionals to help us?The first thing to know is whether they are soft or hard nodules. If they are hard nodules, it is generally recommended to remove them surgically. If they are soft, the body can normally absorb them by resting the voice. In the case of singers and people who use their voice a lot in their daily lives, it is advisable to start doing voice rehabilitation therapy as soon as possible to prevent them from reappearing, whether soft or harsh.

In general, there are certain groups of sounds or musical notes that most people find difficult to reach, and it is precisely these notes that usually cause nodules. You don’t have to be a singer to reach these notes, because a lot of people do them while talking, while shouting it’s very normal to do it. Our technique works particularly well because it is based on learning the correct use of specific vocal muscles so as not to strain this area. When you learn to deal with this group of conflicting sounds, the whole voice benefits. In other words, we strive to make the voice work with the minimum of effort to get the most out of it.

If they take away your ability to communicate fluently, it makes it totally impossible for you, even if the voice is not your working tool.

What is the impact of the nodules on the quality of life of those who use the voice as a working tool?It’s an impact far greater than anyone who hasn’t experienced it can imagine. If they take away your voice, they take away your identity and your ability to communicate fluently. This makes you very impossible, even if the voice is not your working tool. Two years ago we started working with a 53 year old man who had soft nodules. He told us it was a horrible experience and he never wanted to go through that again. Fortunately, he is very consistent and takes his vocal training very seriously, and has no longer felt any discomfort while speaking or singing.

Symptoms are usually felt when the nodules have already appeared; That’s why it’s important to spend time using your voice correctly before they appear.

Can nodules be prevented? How?On the one hand, learn to use the voice. As we mentioned, vocal nodules appear due to excessive and continuous friction of the vocal cords. It is very difficult to tell without help that you are using your voice in this way, because the vocal cords cannot be seen with the naked eye. This is why the symptoms usually make themselves felt when the nodules have already appeared; and for this too it is important to spend time using the voice correctly before they appear. And, on the other hand, they can also be avoided by taking care of your voice. It’s not about staying home without going out with friends to have a good time, but it’s about being aware of anything that negatively affects the voice, like smoking and reflux that we explained earlier.

​In our case, as soon as we clearly suspect there is an injury, we send the person for examination and normally we stop training until we have the report. If there is no injury, we look for other possible causes, such as inflammation due to air conditioners, lack of hydration, poor diet (due to reflux)… If there is injury , we coordinate the work with the specialist who has to do the examination if necessary intervene surgically.

If the intervention is necessary, we wait until the person completes the treatment indicated by their specialist before resuming their voice training. In the event that the intervention is not necessary, we treat the voice carefully, testing little by little how far we can put it down at each moment. In both cases, after some time, we recommend a new examination to ensure that the lesion has completely regressed.

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