Exam Vocabulary

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Hi Doctor, after a recent exam with a fiberscope, my ENT wrote, "He has got a little bit of vocal cord edema and he has what I deem a proto nodule on the left cord."

I am a professional singer and have had a busy schedule, sometimes two shows a day.  Since that exam, I have cut back my performances, focused on rest, water, and a "back-to-basics" approach to vocalizing. I am doing much better, and continue to see improvements each week. My biggest hurdle at this point is trying to get my head voice back.
My question is:  What does "proto nodule" mean?  Thank you very much!
Ken Wanovich
James P Thomas MD's picture
Submitted by James P Thomas MD on Sat, 2012-04-07 12:47

Dear Ken,
Your question is a good one and one that your doctor should be able to answer.
Myself, I see nodules come in all different sizes. Since a nodule is basically a callus, really just like the ones you get on your hands from overuse - that is, a nodule is a thickening of the skin from rubbing and overuse - the size of nodules depends on how much the vocal cords have been overused.
In order to test the size of the swelling, basically the higher and softer one can sing, the smaller the swellings are on the vocal cords. Conversely, the larger the swellings are on the vocal cords, the more that the high and soft singing voice will be impaired. See vocal capabilities testing at http://www.voicedoctor.net/Optimal-exam/vocal-capabilities.