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Vocal Cord Anatomy — Surgical View (1 of 8) Mucosal “Stretch” Demonstration (2 of 8) Skin-Stretch Analogy (3 of 8) Limited Excision (4 of 8) Vibratory Blur Analogy (5 of 8) Post-Excision Result (6 of 8) To review: Preop (7 of 8) Final result (8 of 8) Polypoid Vocal Nodules Polypoid vocal nodules (1 of 4) Incomplete closure (2 of 4) Polypoid vocal nodules (3 of 4) Polypoid vocal nodules (4 of 4) Example 2 (Vocal Cord ‘Wounds,’ 2 Hours after Surgery) Polypoid nodule, open phase (1 of 8) Polypoid nodule, closed phase (2 of 8) Polypoid nodule, right and left cords (3 of 8) Segmental vibration (4 of 8) Post-surgery wounds (5 of 8) Post-surgery, closed phase (6 of 8) Post-surgery, open phase (7 of 8) Post-surgery, precise match (8 of 8) Vocal Nodules, Before & After Surgery Vocal nodules (1 of 10) Prephonatory instant (2 of 10) Translucency (3 of 10) Open phase (4 of 10) 1 week after surgery (5 of 10) 1 week after surgery (6 of 10) 1 week after surgery (7 of 10) Vocal nodules: 10 weeks after surgery (8 of 10) 10 weeks after surgery (9 of 10) 10 weeks after surgery (10 of 10) Example 2 Vocal nodules (1 of 4) Phonation (2 of 4) After surgery (3 of 4) After surgery (4 of 4) Example 3 Vocal nodules, before surgery (1 of 4) Before surgery (2 of 4) After surgery (3 of 4) Vocal nodules, after surgery (4 of 4) Example 4 (Pre- & 1 Week Post-removal) Vocal nodules (1 of 8) Muscular tension dysphonia (2 of 8) Open phase (3 of 8) Closed phase (4 of 8) Post-op, one week (5 of 8) Phonation (6 of 8) Open phase (7 of 8) Closed phase (8 of 8) Vocal Nodules, Spicule-shaped Vocal nodules (1 of 3) During phonation (2 of 3) Closed phase (3 of 3) Example 2 Vocal nodules (1 of 4) Small nodules (2 of 4) Phonation (3 of 4) Open phase (4 of 4) Fibrotic Nodules Fibrotic nodules (1 of 5) Fibrotic nodules: full-length vibration at low pitch (2 of 5) Fibrotic nodules: full-length vibration at low pitch (3 of 5) Fibrotic nodules: segmental vibration at high pitch (4 of 5) Fibrotic nodules: segmental vibration at high pitch (5 of 5) Example 2 (Fibrosis as a Base to Nodules, Before & After Surgery) Bilateral polypoid nodules (1 of 8) Narrow-band lighting (2 of 8) Closed phase (3 of 8) Open phase (4 of 8) Two weeks after surgery (5 of 8) Phonation (6 of 8) Margin fibrosis (7 of 8) Open phase (8 of 8) More Examples of Vocal Nodules Vocal nodules (1 of 4) Prephonatory instant (2 of 4) Open phase of vibration (3 of 4) Closed phase of vibration (4 of 4) Example 2 Vocal nodules (1 of 2) Vocal nodules (2 of 2) Example 3 Vocal nodules (1 of 1) Example 4 Vocal nodules (1 of 1) Example 5 (Vocal Nodule Postop Irregularity yet Match & Flexibility) Large vocal nodules (1 of 8) Narrow band light (2 of 8) At B2 (3 of 8) At A5 (4 of 8) One week after surgery (5 of 8) Prephonatory instant (6 of 8) Closed phase (8 of 8) Open phase (7 of 8) Search not Only for Nodules, but Also for Segmental Vibration and Look at the Posterior Commissure for MTD Open phase (1 of 4) Closed phase (2 of 4) Segmental vibration (3 of 4) Posterior commissure (4 of 4) Ask Both Voice (via vocal phenomenology) and Larynx (via a motivated examination) to Give up their Secrets Obvious mucosal injury (1 of 3) Vocal nodules (2 of 3) Capillary ectasia (3 of 3) Mottled Vocal Cord Mucosa May Hide Glottic Sulci Vocal cord swelling and mucosa (1 of 4) Same view under strobe light (2 of 4) Closed phase (3 of 4) Glottic sulcus is visible (4 of 4) Vocal Nodules, Leukoplakia, & Capillary Ectasia Abducted breathing position, standard light (1 of 4) Vocal nodules, leukoplakia, and capillary ectasia (2 of 4) 6 months later (3 of 4) Near closed phase: 6 months later (4 of 4) Share this article Nodules and Other Vocal Cord Injuries: How They Occur and Can Be Treated This video explains how nodules and other vocal cord injuries occur: by excessive vibration of the vocal cords, which happens with vocal overuse

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