Abstract

Background: Hoarseness of voice is one of the common symptoms amongst patients visiting ENT out patient department. Vocal nodule is a benign laryngeal lesion mainly caused by vocal abuse which accounts for 12 % of all the patients presenting with hoarseness of voice. If the vocal nodules are diagnosed early, conservative management in the form of voice rest, vocal hygiene and medical treatment can lead to complete regression of nodules and can give complete relief from the symptoms. Conservative management still has a role in the patients where the diagnosis is done late, and the fibrosis has set in to form hard nodules. In these patients conservative management helps to give some symptomatic relief, gain confidence of the patient and avoids recurrence after micro laryngeal surgery. 18 such patients presenting to ENT OPD diagnosed with vocal nodules were included in this study to find benefit of conservative treatment which showed satisfactory results.

Results: The patients with vocal nodules underwent Video-stroboscopic examinations, 10 out of 18 patients showed complete regression of vocal nodule at the end of 3 months. The GRBAS score showed improvement in 13 out of 18 patients. Mean fundamental frequency, shimmer, jitter and Noise to harmonic ratio was seen to significantly improve in 12 patients of 18.

Conclusion: Improvement in all the 3 parameters i.e. perceptual, instrumental and acoustic assessment at the end of 1 month usually reflects complete regression of vocal nodules at the end of 3 months with conservative line of management. Surgical intervention is usually required if the diagnosis is made after 6 months of onset of the symptoms.