NODULES of the vocal cords is an affliction that is as disquieting to the patient as it is puzzling to the laryngologist. Ever since Tuerck first described the condition, in 1868, discussion of the etiology, the histological nature, and the therapy has not ceased. Generations of laryngologists have argued whether the nodules are genuine tumors, whether they are mechanical irritations, or whether, as Fraenkel1 suggested, they originate in the surface glands. As late as 1933 Nadoleczny2 stated that "the development of singer's nodes is even today not completely understood." The voluminous literature can be found in the bibliography of Tarneaud's3 monograph.
General agreement has been reached on the assumption that nodules of the cords are invariably the result of misuse or abuse of the voice. This very fact places the nodules in a special category. They are visible organic changes that are the consequence of a functional