▁primary ▁di agnostic ▁method . ▁V ocal ▁fol d ▁nod ules ▁inter f ere ▁with ▁the ▁v ib rat ory ▁characteristics ▁of ▁the ▁vocal ▁fol ds ▁by ▁increasing ▁the ▁mass ▁of ▁the ▁vocal ▁fol ds ▁and ▁changing ▁the ▁configuration ▁of ▁the ▁vocal ▁fol d ▁closure ▁pattern . ▁Due ▁to ▁these ▁changes , ▁the ▁quality ▁of ▁the ▁voice ▁may ▁be ▁affected . ▁As ▁such , ▁the ▁major ▁per cept ual ▁signs ▁of ▁vocal ▁fol d ▁nod ules ▁include ▁vocal ▁ho ars eness ▁and ▁breath iness . ▁Other ▁common ▁sympt oms ▁include ▁vocal ▁fat igue , ▁sor eness ▁or ▁pain ▁later al ▁to ▁the ▁l ary nx , ▁and ▁reduced ▁frequency ▁and ▁intensity ▁range . ▁Air flow ▁levels ▁during ▁speech ▁may ▁also ▁be ▁increased . ▁V ocal ▁fol d ▁nod ules ▁are ▁thought ▁to ▁be ▁the ▁result ▁of ▁vocal ▁fol d ▁t issue ▁tra uma ▁caused ▁by ▁excess ive ▁mechanical ▁stress , ▁including ▁repeated ▁or ▁chron ic ▁vocal ▁over use , ▁ab use , ▁or ▁mis use . ▁Pred is pos ing ▁factors ▁include ▁profession , ▁gender , ▁de h yd r ation , ▁resp ir atory ▁in fection , ▁and ▁other ▁infl am mat ory ▁factors . ▁ ▁For ▁professional ▁voice ▁users ▁as ▁well ▁as ▁individuals ▁who ▁frequently ▁experience ▁ho ars eness , ▁vocal ▁h yg iene ▁practices ▁are ▁recommended ▁for ▁the ▁prevent ion ▁of ▁vocal ▁fol d ▁nod ules ▁and ▁other ▁voice ▁dis orders . ▁V ocal ▁h yg iene ▁practices ▁include ▁three ▁components : ▁reg ulating ▁the ▁quantity ▁and ▁quality ▁of ▁voice