Is surgery the only treatment for early vocal nodules?
Q: I am 32 years old. I had a severe sore throat about a month ago. Initially the voice was hoarse but I didn't take it seriously thinking that I might get alright after a couple of days. But it started worsening and finally I was unable to talk. This happened within a week from the day I had sore throat. Later, I consulted an ENT surgeon who advised me take some antibiotics for a week but it still did not improve. Then I had video endoscopy and the doctor diagnosed it to be chronic laryingitis. Again I was asked to continue antibiotics. After a week, the endoscopy was repeated and I was told there was some improvement and the final diagnosis was early vocal nodules. Now my voice is perfectly alright and I am able to talk as before except that I have a mild cough and cold. At this stage I am advised by the doctor to undergo a laparoscopic surgery to knock out the nodule, since it might aggravate. I need your suggestion on this. What is the reason for this sort of a problem? Why does it occur? Is it necessary to go in for surgery immediately or can I wait for sometime? Will I retain my original voice after the surgery? Will the nodule recur? If so, what precautions should I take?
A:By your history : I shall attempt to answer your questions. If you have a printout/ recording of the videoendoscopy: and can send it as an attachment, it would help much more to give a diagnosis. Your initial hoarseness after sore throat seems to be a downward spread of the same throat infection. It did not improve as you may not have taken adequate voice rest, or suffer from acidity and reflux. Chronic laryngitis is a continuation of the same process. Early vocal nodules can be present. If you feel your voice is normal. You do not need to go for urgent surgery but need voice rest. No whispering and shouting. And possible treatment for acid reflux. If the nodules persist, and your voice is hoarse, you would need microlaryngeal surgery. Your voice should return then to normal. The nodules can re-occur if voice misuse continues/ acid reflux continues.