Sounding hoarse? You may have bamboo nodes in your voicebox

As ENT surgeons, we often see patients who are hoarse. Many of them are professionals who rely on their voice to communicate at work. Subtle changes in voice quality often go unnoticed by many of us, but they can affect the performance of singers and teachers.

I recently saw a patient who noticed that her voice was a little breathy and that she had lost the ability to sing certain notes. She did not smoke and consumed little alcohol.

Laryngeal videostroboscopy in clinic allowed me to examine her vocal folds in detail. This is the video of the examination. You will notice subtle slightly yellow swellings in the mid-third of her vocal cords.

These “nodules” were first described in 1959 by Scarpelli in a patient with a rare autoimmune condition called Systemic Lupus Erythematosus (SLE). Subsequently, these nodules were found in Rheumatoid Arthritis patients and earned the name “Rheumatoid Nodules”. However, with time, it was observed that these nodules were not confined to Rheumatoid patients but seen in many patients with connective tissue diseases. In 1993, Hosako observed a similarity between these lesions and the nodes of a bamboo stem, and coined the term “bamboo nodes”!

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