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Noduli delle corde vocali

I noduli delle corde vocali interessano di norma entrambe le corde . I noduli vocali sono costituite da un ispessimento a carico delle corde vocali. I noduli delle corde vocali sono causate principalmente da abuso cronico della voce. nelle forme iniziali i noduli delle corde vocali possono regredire normalizzando l'uso della voce, meglio se mediante trattamento logopedico. I noduli delle corde vocali possono recidivare se persistono le condizioni che ne hanno causato l'insorgenza (abuso o uso cattivo della voce).

 

Che cosa sono i noduli delle corde vocali?

 

I noduli delle corde  vocali sono costituiti da un ispessimento localizzato, in genere bilaterale, a carico delle corde vocali.  Si formano a seguito di ripetuti piccoli traumi, determinati dallo sfregamento delle corde vocali durante l’emissione vocale, la tosse o lo schiarirsi della voce.

 

Quanto sono diffusi i noduli delle corde  vocali?

 I noduli delle corde vocali rappresentano il 20% delle lesioni laringee benigne e sono più frequenti nel sesso femminile e nei cantanti ; si manifestano soprattutto  tra i 20 e i 50 anni di età.

 



 

 

Quali sono le cause?

L’abuso (surmenage) o il cattivo uso (malmenage) della voce sono le cause scatenanti.

  • Uso eccessivoo improprio della voce (parlare a voce alta, gridare)
  • Uso professionaledella voce (oratori, cantanti)
  • Tosse persistente
  • Schiarirsiripetutamente la voce
  • Scarsaigiene vocale.

 

Quali sono i sintomi dei noduli delle corde vocali?

I noduli vocali sono causa didisfonia(alterazione qualitativa o quantitativa della voce) che, inizialmente si manifesta solo dopo affaticamento vocale ma che nel tempo diviene permanente;raucedine; difficoltà di emettere le tonalitàpiù alte o di alzare il tono della voce; necessitàdi schiarirsi ripetutamente la voce. 

Come si fa la diagnosi dei noduli delle corde vocali?

L’esame laringoscopico consente di evidenziare la presenza di un ispessimento nodulare della mucosa delle corde vocali, ben circoscritto, di  solito bilaterale, localizzato al punto di passaggio tra ilterzo medio e il terzo anteriore delle corde vocalio, meno frequentemente alterzo medio. La motilità laringea appare conservata e si evidenzia una mancata chiusura del piano glottico durante la fonazione.



Trattamento

Soprattutto nelle forme iniziali possono regredire normalizzando l’uso della voce, meglio se mediantetrattamento logopedico. Nei casi in cui non si raggiunge la guarigione con questo trattamento è necessario l‘exeresi in microlaringoscopiadiretta in narcosi. Nel post-operatorio è necessario che il paziente seguo riposo vocale di alcuni giorni seguito, eventualmente, da una rieducazione ortofonica.

 

Prognosi

I noduli delle corde vocali possono recidivare se persistono le condizioni che ne hanno causato l’insorgenza (abuso o cattivo uso della voce).

 

 





 

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