What actually are nodules in the throat....what causes them? I have a five year old daughter who has them and they have been monitoring them. The doctor says they have now enlarged and wants to remove them. He says he will burn them off...is there a possibility they will grow back? Her voice is always hoarse. She has had ear problems for sometime and has had tubes. Could the ear problems have caused these nodules? Thanks for your help!
Reply: --------------------------
I assume you are speaking of vocal nodules. In children, the most common cause of vocal nodules is chronic vocal abuse - frequent yelling and screaming. Small nodules composed of scar tissue form - one on each vocal cord - just beneath the lining. They can be diagnosed usually during an office examination by an otolaryngologist. The treatment of choice for vocal nodules in children is speech therapy intervention. Speech therapy is usually quite successful in alleviating the problem and underlying cause. However, the therapy may be required for several months to a year in order to successfully treat the problem. Surgery for vocal nodules in children should be reserved only for severe cases in which speech therapy has failed. Surgery is not considered a primary treatment for vocal nodules - although it is sometimes offered as primary treatment for adults with large mature vocal nodules. Furthermore, laser surgery for removal of vocal nodules can result in permanent scarring and permanent alteration in vocal quality. Therefore most otolaryngologists with expertise in voice recommend against using the laser for ablation of vocal nodules, favoring microdissection of the vocal nodules with preservation of the lining of the vocal cord to minimize scarring. I would again re-emphasize the need for speech therapy evaluation and intervention for vocal nodules, especially in children, before surgery is contemplated.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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