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What Are Reactive Nodules?

Reactive nodules, sometimes referred to as singer's nodules, are usually seen in heavy smokers or performers who have spent many years singing. The act of smoking creates an immense strain on the vocal cords due to the chemicals and tar present in cigarettes. Using your voice to sing powerfully and prolong notes can also put a strain on your throat and result in reactive nodules developing.

  1. Causes

    • A smoker's cough can be a trigger to reactive nodules developing, as it creates a similar pressure on the larynx as when a singer sustains a note. Talking or whispering too much, laughing heartily or crying excessively can also trigger the development of reactive nodules. According to speech and language pathologist Dr. Caroline Bowen, poor levels of fitness and nutrition and depression can also contribute to singer's nodules forming.

    Diagnosis

    • Reactive nodules can be seen via a microlaryngoscopy examination, which is used to identify and treat problems relating to the throat and voice box. The throat is magnified during the procedure using a medical microscope, digital video enhancement or through insertion of an endoscope. A surgeon sometimes removes a small part of the inner throat lining during the procedure, which is then taken for laboratory testing. Depending on the seriousness of the problem, a laser may be used to remove reactive nodules from the voice box.

    Dangers

    • Reactive nodules are made from rigid skin growths around the voice box, and usually measure a few millimetres in diameter. Reactive nodules are almost always benign growths, meaning they don't usually develop into cancer tumors. However, they can alter the quality of speech, resulting in grainy voices where words are difficult to understand. This is due to nodules inhibiting the vocal cords' capacity to make the necessary shifts in air pressure to produce human speech.

    Symptoms

    • Hoarseness, a dry itching throat and pain experienced when talking are other common symptoms of reactive nodules. Singers may also find that their range and depth of singing is restricted by the presence of reactive nodules. Theater actors and public speakers can also suffer from reactive nodules, often resulting in them ending their careers prematurely. Surgery can usually remove reactive nodules, but voice quality may be permanently damaged.

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