From Big Medical Encyclopedia

UZELKY of SINGERS (noduli vocales; synonym: fibrinoid and hyaline

small knots, small knots of shout, chord it is nodosa, chorditis tuberosa) — limited, usually symmetric, thickenings at free edges of phonatory bands.

At. items have an appearance of small protrusions by diameter several millimeters located most often on border of a front and average third of phonatory bands (voice folds, T.).

Most often such educations come to light on phonatory bands at singers, teachers, actors, etc., the profession to-rykh is connected with big load of the golosoobrazuyushchy device. Emergence At. the item can be caused by the wrong voice training, and also performances in the period of diseases of golosoobrazuyushchy bodies. To education At. the item are promoted by smoking and alcohol intake. At an excessive tension of phonatory bands in them there come circulator frustration with acute hypostasis and destructive changes of membranes of vascular walls, to-rye become permeable for a liquid part of plasma in the beginning, and then and for proteins. Outside a vascular wall squirrels are curtailed, condensed and postponed in a stroma in the form of homogeneous translucent masses. The small knot formed on their place consists of the fibrous fabric covered with a multilayer flat epithelium without the expressed keratinization.

Emergence of the small knots disturbing a full smykaniye of phonatory bands at a conversation and singing leads to simultaneous formation of two tones of different height and loss of purity of a sound (see the Dysphonia). If in these conditions speech activity (i.e. tension of phonatory bands) continues, frustration of all muscular device of a throat can develop.

The diagnosis is made on the basis of a characteristic laringoskopichesky picture (see L an aringoskopiya) — than existence small, is more often symmetric, thickenings on both phonatory bands, to-rye at phonation adjoin, and the glottis which is not closed completely gets a form of hourglasses (see tsvetn. the tab. to St. Laryngitis, Laringoskopiya, t. 12, Art. 65, fig. 13). At a stroboskopiya (see) can be observed as the uniform synchronous fluctuations of phonatory bands of small amplitude disappearing only at the time of a smykaniye of small knots at phonation and sharp oppression of fonatorny fluctuations.

Treatment in an initial stage of development conservative. The small knot can resolve (at strict observance of the mode of silence) under the influence of physiotherapeutic procedures: an electrophoresis (see) solution

of the sung along potassium on area of a throat, an outside or endolaryngeal fonoforez with a hydrocortisone (see. Ultrasonic therapy), reception of aitigistaminny substances (see). The created small knots delete under control of an operative microscope (see).

The forecast at timely treatment, as a rule, favorable.

Prevention comes down to the correct statement of breath and observance of a work-rest schedule by persons, the profession to-rykh is connected with big load of the golosoobrazuyushchy device, and also to abstention from smoking and alcohol intake.

Bibliography: Vasilenko Yu. S. and

Ivanchenko of G. F. Mikrolaringo-hirurgiya in treatment of some diseases of a throat at professionals of a voice, in book: The sparing methods in otorinolar., under the editorship of D. I. Tarasov, etc., page 79, M., 1976; Vasilenko Yu. S. and N and - to about l and e in with to and I am V. P. Use of a fonoforez of a hydrocortisone at small knots and polyps of voice folds, Vestn. otorinolar., No. 3, page 59, 1975; Preobrazhensky Yu. B., Chire sh-to and D. G. and Galperin N. S. Mikrolaringoskopiya's N and endolaringeal-ny microsurgery, M., 1980; Klein-sasser O. Mikrolaryngoskopie und endolaryngeale Mikrochirurgie, H. N. O. (Berl.), Bd 22, S. 33, 69, 1974, Bibliogr.; Strong M. S. a. Vaughan C. W. Vocal cord nodules and polyps, The role of surgical treatment, Laryngoscope (St Louis), v. 81, p. 911, 1971.

V. A. Zagoryanskaya-Feldman.