Hello and welcome to this video about vocal fold swelling and nodules.
Vocal fold swelling is exactly what it sounds like. The vocal fold tissue becomes swollen
which makes it harder for them to seal completely as they vibrate. To make sound, this creates an
air leak which we hear as hoarseness. Vocal fold swelling is typically caused by overusing your
voice. For example, screaming for several hours at a sports game is definitely going to cause some
vocal fold swelling. When we scream or shout, we press our vocal folds together pretty hard.
The vocal folds swell to protect themselves from that pressure. Nodules are a more advanced form of
vocal fold swelling. They are usually the result of voice abuse, misuse, or overuse over a period
of time. This creates bilateral lesions or bumps on the vocal folds which are similar to calluses.
Again these lesions make it hard for the vocal folds to seal completely as they vibrate to make
sound and we hear this as hoarseness. Both vocal fold swelling and nodules also cause lowered pitch
or increased difficulty singing higher pitches. This is because our vocal folds stretch long
and thin when we sing high notes. Swelling makes it harder for that tissue to stretch.
Vocal fold swelling and nodules also typically create delayed onsets. This happens when we
try to speak or sing and nothing comes out for a second. It sounds like this.
[onset delay singing]
The swelling causes increased effort in order to get the vocal folds to start to vibrate.
Now the good news is that vocal fold swelling and nodules typically will go away with voice therapy.
The gold standard for voice therapy is meeting one-on-one with a knowledgeable provider.
The information in this video is intended to get you started until
you can meet with someone one-on-one. To heal from vocal fold swelling or nodules,
we have to stop the behavior that caused the swelling or nodules in the first place.
It's very important that you identify these behaviors so you know what to modify or stop.
Let's cover some of the most common behaviors and talk about how to address them
first. Yelling, screaming, or speaking habitually over loud background noise.
Think about where and when you're doing this and how you can eliminate adjust or decrease these
behaviors. For example, if you're a classroom teacher or an exercise instructor can you
start using a microphone while you teach. Next, harsh or habitual throat clearing or coughing.
Clearing your throat is grinding your vocal folds. Coughing is banging your vocal folds together.
Both of those are going to cause more swelling. Instead, try taking a drink of water.
If you still have to cough or clear, do so as gently as possible.
Next, speaking at inappropriate volumes either too loud or too soft. For example,
maybe you are living with or caring for someone who is hard of hearing and you find yourself
shouting throughout the day. Do what you can to help them obtain or adjust hearing aids.
Then make sure that when you're speaking, you are close to them,
facing them so they can see your face. And you're slowing down when you speak with them.
Next, speaking or singing for too long at one time. Plan vocal naps instead. For example, if
you are a teacher, plan a prep period in between blocks of teaching. Consider your total vocal
load or how much you're using your voice every day... where and how can you decrease that load.
Next, speaking or singing with habitual glottal attacks. A glottal attack sounds like this.
I eat eggs every evening.
This bangs the vocal folds together. Instead, use your air to smash the words together like this.
I eat eggs every evening.
When you have a sentence that starts with a word with a vowel,
use a little small H to start the word.
Hide eggs every evening.
Next, speaking or singing with habitual vocal fry. Vocal fry sounds like this.
This is me speaking with a lot of vocal fry. This is common in American speakers partially
because questions go up and we don't want to sound like we're always asking a question
so we tend to drop the end of our sentences into vocal fry. Next, speaking or singing
without enough breath support. Now vocal fry is actually one of the things that happens when we
don't have enough breath support. When there's not enough air flowing through our speech, the vocal
folds grind against each other. It's causing this sound that we call vocal fry. When we increase our
breath flow, the sound becomes more clear as the vocal folds can vibrate more efficiently.