Does Voice Therapy Cure All Vocal Fold Nodules

Introduction: Vocal nodules are known to be one of the most common benign lesions, commonly situated at the junction of anterior one third and posterior two third of vocal folds. Voice therapy is considered to be the gold standard of treatment of vocal fold nodule. Objectives: To determine the efficacy of voice therapy in the treatment of vocal fold nodules and to identify any possible reason for failure to voice therapy in managing vocal fold nodules. Materials and methods: A prospective study, conducted over a period of 6 months. Eighteen adult patients diagnosed with vocal fold nodules at a tertiary care hospital were sub jected to 6 weeks of voice therapy. Pre and post therapy sub jective (Voice Handicap Index-10) and objective (Rigid fiber optic laryngoscopy) evaluation was done. Patients with no improve­ ment after 6 weeks of voice therapy underwent micro laryngeal surgery. All patients were followed up at 3 months and 6 months. Results: In majority of patients, objective and subjective voice outcome parameters were significantly improved after voice therapy. Although a few cases showed no significant improvement after therapy, they recovered completely after microlaryngoscopic surgery. It was found that patients who required surgery even after voice therapy had hard nodules.