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Signs and symptoms of Vocal nodules Signs and symptoms of Vocal nodules People with vocal cord nodules may experience and/or report the following signs and symptoms: Vocal hoarseness Vocal raspiness Breathiness when speaking Difficulties with maximum phonation time (MPT) Decreased vocal pitch range Vocal fatigue Strain when speaking Throat and/or neck pain Too high or too low of a pitch (Informedhealth.org, 2024) Vocal fold nodules are more common in younger patients (under 19 years old), females, and professional voice users such as teachers and singers (Won et al., 2016)