<prompt> A lady singer with singers node with history of reflux, the best treatment is:Voice therapy and PPIMicrolaryngeal excision and PPILASER excision and PPIVocal cord stripping  <response>: a Voice therapy and PPIRef. Cummings, 6th ed., 906; Scott Brown, 8th ed., Vol 3; 951; 984Initial 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 Reinkes oedema. 