Bilateral vocal nodules viewed with false color imaging with a Pentax high definition endoscope

This patient noted discomfort with singing. The vocal cord swellings which are also known as nodules require that he hold the vocal cords slightly apart. This allows air leak, impairs his upper vocal range and creates a muscle tension with the resulting discomfort during singing.

vocal nodules

These are vocal nodules in a twentysomething vocal overdoer. She works in the food service industry and frequently sings on the job. The images are taken with a KayPentax 70° rigid endoscope at high definition.

Vocal cord nodules during abduction

Elizabeth is in her 20s and began singing about 3 years ago. About 1 year ago, she noted some roughness in her singing voice. She loves to talk and rates herself a 7/7 on the talkativeness scale and a 7/7 on the loudness scale. Here are her vocal cords when I met her.

Vocal nodules - 27 year old

27 yo teacher with chronic hoarseness. Treated surgically. The top photo shows the vocal nodules touching each other and interrupting vibrations. The lower 2 photos are taken six weeks post surgery. The bottom photo demonstrates well the muscle memory from having lived with vocal elevations for some time.

Vocal nodules - 19 year old

19 yo female vocal overdoer with a singing impairment. The 2 thickenings or elevations in the center of the vocal cords represent vocal nodules. That is, thickening of the skin or mucosa where the vocal cords tend to collide with each other when making sound. Left nodule has some tiny blood vessels within it.


Vocal cord nodules are swellings on the vocal cords caused by vocal overuse. They can be visualized with a procedure called laryngoscopy. Dr. James Thomas takes you on a tour of your throat and shows some of the variation of vocal nodules and how they consistently impact or impair the voice.