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The diagnosing vocal fold nodules typically includes a comprehensive analysis of medical and voice history, a physical examination of the head and neck, perceptual evaluation of voice, and visualization of the vocal folds ^[1]. Visualization is considered to be the main method of diagnosis as perceptual evaluation, which includes acoustic and aerodynamic measures, alone is insufficient ^[2]. Laryngeal videostroboscopy, an imaging technique, is commonly used to view the vocal folds: this procedure can be performed nasally or orally ^[1]. Vocal fold nodules are most often characterized as bilaterally symmetrical whitish masses ^[1], and tend to form at the mid-point of the vocal folds ^[2]. Nodules may prevent complete closure of the glottis, also known as glottal closure, and their presence may lead to an hourglass-shaped glottal closure ^[1]. Voice problems may result from the presence of vocal fold nodules ^[3]. They are diagnosed based on the presence of perceptual features not explicable by other causes ^[3]. Such symptoms include: vocal fatigue, breathiness, loss of high pitch notes, lack of vocal control, or increased phonatory effort (ie. increased effort to produce sounds) ^[3].

^ ^a ^b ^c ^d Johns, M. M. (January 01, 2003). Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Current Opinion in Otolaryngology & Head and Neck Surgery, 11, 6, 456-61.
^ ^a ^b Pedersen M, McGlashan J. Surgical versus non-surgical interventions for vocal cord nodules. Cochrane Database of Systematic Reviews 2012, Issue 6. Art. No.: CD001934. DOI: 10.1002/14651858.CD001934.pub2
^ ^a ^b ^c Verdolini, K., Rosen, C.A., & Branski, R.C. (2014). Classification Manual for Voice Disorders-I. New York, New York: Psychology Press.

[Johns,_M._M-1] Johns, M. M. (January 01, 2003). Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Current Opinion in Otolaryngology & Head and Neck Surgery, 11, 6, 456-61.

[Pedersen-2] Pedersen M, McGlashan J. Surgical versus non-surgical interventions for vocal cord nodules. Cochrane Database of Systematic Reviews 2012, Issue 6. Art. No.: CD001934. DOI: 10.1002/14651858.CD001934.pub2

[Verdolini-3] Verdolini, K., Rosen, C.A., & Branski, R.C. (2014). Classification Manual for Voice Disorders-I. New York, New York: Psychology Press.

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