[Project Zipped Lips, Week 2] The One With The Nodes

I figured while documenting my inner journey is all well and good, it would probably be a bit more helpful if Project Zipped Lips also documented my outer, physical journey–that is, dealing with nodes.

In actuality, vocal nodules aren’t as scary as Pitch Perfect makes them out to be (or maybe I’m just telling myself that so that I don’t collapse in a blubbering heap).  Most of the time, surgery isn’t even considered an option, unless of course you’ve got hard nodules from years and years of abuse.  If you catch them at their early onset, such as mine were, the standard treatment is selective voice rest and therapy, or, as I like to put it, “checking into rehab for vocal abuse.”  (Sounds more hardcore, don’t it?)

Symptoms of vocal nodules include hoarseness, difficulty reaching original high notes, increase phlegm production, and dry throat.  If you lose your voice periodically, and for more than two weeks at a time, I suggest you do get checked out by an ENT because while nodules themselves are benign–they’re like calluses that form on the vocal cords–there can be similar growths on your vocal folds that can cause the same symptoms, such as polyps or cysts, which are more likely to involve surgical intervention.

The primary way of figuring out if you have a nodule, a cyst, or a polyp is a laryngovideoendostroboscopy, which is when they jam a camera down your throat with a strobe light attached to the end so they can see, in slow motion, the movements of your vocal folds, and the nodules in question.  Which leads me to the contents of this blog post: the results of my recent LVES examination, posted here in their entirety because, well, at least some of it is understandable to human beings.

Special thanks to the Voice and Swallowing Center of St. Luke’s Medical Center-Global City for their amazing service!

Patient Info


(There was actually a photo enclosed with the report, but it was hideous, so I’m using this one instead.)

Last Name: Torres
First Name Middle Initial: Frankie
Gender: Female
Date of Birth: 03/07/1993
Patient ID: Out-Patient
Address1: <<actuallyfrankie.wordpress.com>>
Original Complaint: Hoarseness
Patient Primary Diagnosis: Pre-nodular swelling
Patient Secondary Diagnosis: Chronic posterior laryngitis (swelling of the larynx due to a degree of acid reflux)
Smoking: Non-smoker
Alcohol Consumption: Rarely (Try: NEVER)
Occupation: Student

Exam System Info – General

Exam Original Date: Tue Jul 30, 2013 08 28 40 AM Last Modified Date: Tue Jul 30, 2013 08 28 40 AM
Examining Facility: St. Luke’s Medical Center – Global City

Exam Detail

Vocal Fold Edge-Left: irregular Vocal Fold Edge-Right: irregular
Glottic Closure: 3. Posterior gap Amplitude-Left: 1. Normal
Amplitude-Right: 1. Normal Phase Closure: 2. Open phase predominates
Mucosal Wave-Left: 1. Normal Mucosal Wave-Right: 1. Normal
Vertical Level of Approximation: 1. Equal Vibratory Behavior-Left: 1. Always fully present
Vibratory Behavior-Right: 1. Always fully present Phase Symmetry: 1. Regular
Ventricular Folds (Symmetry): 1. Equal movement both folds Ventricular Folds (Movement): 1. Normal
Periodicity (Regularity): 1. Regular Arytenoids (Symmetry): 1. Equal movement of both arytenoids
Arytenoids (Movement): 1. Normal Hyperfunction: 1. Normal

Exam Summary

Examiner: Dr. Keith Romeo A. Aguilera Endoscope Used: Rigid Endoscope – Kay model 9106
Diagnostician: Dr. William L. Lim Exam Type: Laryngeal Endoscopy with Stroboscopy
Diagnosis: Pre-nodular swelling; Chronic posterior laryngitis Phonation Quality: Hoarse
Resonance: Normal resonance Breath Support: Needs improvement

And now for the parts that will make sense to you–THE PHOTOS.  If you’re squeamish, I suggest you look away.


My vocal folds, covered slightly by my epiglottis–the flap of skin that makes sure when you swallow stuff it doesn’t go down your windpipe instead of your esophagus.  You can’t see the nodes yet, but you can sort-of see the swelling that’s causing my voice to be hoarse.


THE MONEY SHOT!  Note the bump on the vocal fold that’s to the right in the photo (actually the left vocal fold because the photos are, apparently, mirrored) and the slight, wobbly sort of depression just across from it.  The bump is the node, and the wobbly depression thing is what’s known as a contact lesion, which is basically a bit of irritated skin from the node rubbing against it.



Montage sequence!  This is what my vocal cords look like trying to reach high notes.  Usually, they should meet completely and smoothly, producing a nice, clean sound.  However, due to my nodes, they can’t meet smoothly, resulting in all kinds of nasty, pig-getting-slaughtered noises (I’m uploading the video to my Youtube page as soon as I can get my net running fast enough.).

So there you have it, folks!  Those are my nodes.  I promise this will be the last post with a whole lot of squicky photos of my internal anatomy.  I’m going to have my first voice therapy session on Friday, at 10AM, with Ms. Kitchie Molina, so I’ll probably update you after that as to how everything’s going.




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