Thursday, August 16, 2012

Recovery from Vocal Nodules

Hello there. I am a singer/actress, as well as a teacher, so, not uncommonly, about six months ago I began experiencing repeated hoarseness, pain, swelling, and visited an ENT doctor who told me that I had developed "small" vocal nodules. He told me it was nothing to get extremely bent out of shape about and prescribed me a steroid Z-pack and Acid reflux medication (though I personally don't believe I suffer from it...). I continued with my teaching and then actually went on to do a three month show. It has been two months now since the show has ended and I am still experiencing symptoms, though I am not hoarse. My vocal chords literally feel like they are banging together, especially in the mid to lower ranges, and my voice tires very easily and begins producing more vocal fry as a result. So, i revisited my doctor today and he told me I need to take a couple months of moderate vocal rest. One thing he could not quite pin down was why I experience CONSISTENT fullness and pressure in my ears (especially the right one), according to my level of vocal use (when I wake up in the morning, they are clear, the more I use my voice over the day, the more ear pressure I experience). Oh, and I do not suffer from allergies. I have a few questions for you: is this ear pressure/fullness a common side effect of vocal nodules? Also, was my extended singing and teaching possibly permanently damaging to my voice and do you think I will recover with two months of relative voice rest?

Melissa Kim M.S., CCC-SLP replies...
Voice rest is not typically a recommended treatment for vocal fold nodules... although short-term vocal rest may result in some reduction of the nodules, the functional laryngeal behaviors that contributed to nodular development in the first place will usually result in persistence of the lesions. The primary treatment strategy for vocal fold nodules is voice therapy with a speech pathologist who specializes in the treatment of voice disorders. If your vocal fold nodules do not resolve with vocal conservation and voice therapy, surgical removal is an option.  

As to your question regarding ear pressure/ fullness, the answer is no, these are not symptoms typically associated with vocal fold nodules. A second opinion regarding these symptoms may be warranted.

Best of luck to you.

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