Incipient Vocal Nodules in Singers without Voice Complaints

Abstract

Objective: To investigate if the presence of incipient nodular lesions, ie, the presence of turbulence of secretion where the vocal fold preferably contacts during phonation, in patients without voice complaint can affect voice quality and vocal cord vibratory parameters. Method: Twenty female professional voice users (singers) without voice complaints were included in the study. Twelve women had no vocal lesions on a previous videolaryngostroboscopy examination and 8 women showed incipient nodular lesions. The voices were recorded and submitted to auditory perceptual analysis (GRBASH) by 3 different evaluators. The examinations were recorded with a high speed imaging videolaryngoscope equipment (HS Endocam 5560, Richard Wolf GmbH, Knittlingen, Germany), running at 4000 fps. The following parameters were studied: F0, open quotient, speed quotient, time peridiocity index, and the amplitude periodicity index. The data were analyzed by X-CAD software, and t tests were performed to compare the 2 groups. Results: The auditory perceptual analysis of the voices of the 2 groups shows that both the control group and the study group have normal variability of voice quality in all vocal samples. There was no statistically significant difference in the studied vibratory parameters. Conclusion: The presence of turbulence secretion in the transition of the anterior and middle third vocal fold named in the clinical practice as incipient nodules or prenodular lesions does not reflect in changes in voice quality or vocal fold vibratory parameters on high-speed imaging in female singers without voice complaints.