Vocal nodules - is surgery an option for a singer?

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Hello Doctor Thomas,
I am a rock and metal singer from Germany. Four weeks ago I continued singing tracks for my solo album despite having a cold, because I told the label I'd be done by the end of this year. To make matters worse, I decided to yell some parts of the chorus in a way a doc barks (only longer), forcing my voice to sound rough and hoarse while producing the tone. The outcome was great, but I haven't been able to produce a clean, soft sound since then, even my speaking voice sounds hoarse most of the time, and this is four weeks after the recording. My live performance is also far worse than it used to be. So I finally visited a doctor, but he didn't really have time for me, I was in and out within 3 minutes. He said I had vocal nodules and I that needed speech therapy, I could look it up. When I asked the doctor if that would get rid of my nodules, he said I should think of them as chicken eyes on my vocal cords, which didn't answer my question.
Nevertheless, I've cancelled all live appearances and informed my management I couldn't sing for the next couple of weeks. I've already made an appointment with another ENT (hopefully one with more time to explain stuff), but as I was browsing the web for vocal nodules I came across your website and thought: This site is brilliant, maybe Dr. Thomas can answer my questions. Which are those: Firstly, will speech therapy make my vocal nodules go away? And if not: Will it only help my speaking voice or will it improve my singing voice as well? Secondly: Is surgery an option for a singer? I read about Bonnie Tyler and Julie Andrews, and I wouldn't want my voice to be different after the nodules are removed. And finally: I've done the soft singing test from your website (and obviously failed), but I also noticed that there is a section in the middle, that I have failed to produce for over ten years, which leads me to believe I already had nodules before, but never noticed them. Are there non-surgical ways to get rid of old nodules or have they already turned into scar tissue?
Thank you so much for your time and thanks in advance for your answer. Keep up the brilliant work. 
James P Thomas MD's picture
Submitted by James P Thomas MD on Sat, 2012-04-07 13:03

Dear rock 'n roller,

I believe that accurate diagnosis is the most important element of treatment. With a general ENT exam, it may be difficult to distinguish between vocal nodules, vocal polyps, hemorrhagic polyps and small ectasias. I do list the number of physicians around the world, including some in Germany who specialize in voice disorders. You may be more likely to get an accurate diagnosis from one of them - http://www.voicedoctor.net/physicians. Anyway, I couldn't comment on the appropriateness of surgery without knowing exactly what the problem is.