A lady singer with singer's node with history of reflux, the best treatment is:
(a) Voice therapy and PPI(Ref. Cummings, 6th ed., 906; Scott Brown, 8th ed., Vol 3; 951; 984)Initial management of vocal nodule is conservative by advising voice rest and speech therapy. Pharyngo-laryngeal reflux of acid is a common aggravating cause of most of the laryngeal pathologies, so PPI also will benefit this singer.Microlaryngeal excision with knife or LASER is done in persistent nodules despite speech therapyVocal cord stripping is done in keratosis laryngis/ leukoplakia and Reinke's oedema.
Voice therapy and PPI
Microlaryngeal excision and PPI
LASER excision and PPI
Vocal cord stripping
Voice and Speech Disorders