INTRODUCTION The technological developments experienced in the past few years has enabled the panoramic visual- ization of the larynx in semireal phonation situations. In the past, studies of the larynx were limited exclu- sively to qualitative descriptions, whereas today we can quantitatively analyze both the structure and the function of the larynx. Owing to these advances, the study of the type of vocal fold coaptation during phonation and the morphological and functional pa- rameters of the larynx, even in the presence of vocal nodules, has become possible. Morrison et al 1 described muscle tension dyspho- nia (MTD) in which the most common laryngoscop- ic finding is the opening of the posterior glottis dur- ing phonation. Other authors have advocated the following theory for the physiopathology: in MTD, the laryngeal intrinsic muscles are unable to relax properly, functionally inhibiting the contraction of opposing intrinsic musculature. Belisle and Morri- son 2 reproduced in a lab the deviations of glottal clo- sure shape observed in MTD using six excised hu- man larynges. They concluded that the posterior glottal opening might be the result of difficulties in adduction caused by the contraction of the lateral cricoarytenoid and interarytenoid muscles, without the proper relaxation of the posterior cricoarytenoid muscles. According to the authors, this experimental observation should not be classified as objective evi- Journal of Voice Vol. 16, No. 3, pp. 408–414 © 2002 The Voice Foundation Vocal Nodules and Laryngeal Morphology *Paulo Pontes, †Leny Kyrillos, ‡Mara Behlau, †Noemi De Biase, and §Antonio Pontes *Department of Otolaryngology and Human Communication Disorders at Universidade Federal de São Paulo, Escola Paulista de Medicina, Instituto da Laringe, São Paulo, Brazil; †Instituto da Laringe, São Paulo, Brazil; ‡Centro de Estudos da Voz, São Paulo, Brazil; §Undergraduate candidate at Universidade de Campinas, UNICAMP, São Paulo, Brazil Summary: Our purpose was to study the occurrence of vocal fold nod- ules under conditions of habitual vocal abuse associated with increased laryngeal muscle tension, to identify the existence of a relationship be- tween vocal nodules and laryngeal morphology. We studied one group of 30 subjects with vocal nodules, 18 to 50 years old, who were compared with two control groups, one of females and one of males, consisting of 30 subjects each. The parameters evaluated were: type of vocal folds coaptation, glottic proportion (GP) and abduction angle (AA), obtained by videotelelaryngoscopy. In the nodules group, the larynges presented a mean value of GP similar to that of the female group, both of which were lower than the mean GP value of the male group. On the other hand, the mean AA was lower than the one in the female group, and clos- er to the one in the male group. We concluded that vocal nodules were present only in larynges with a predominantly young female morpholo- gy, with functional limitations of abduction. Key Words: Vocal fold nodules—Larynx—Morphology Accepted for publication August 31, 2001. Address correspondence and reprint requests to Paulo Au- gusto de Lima Pontes, MD, Rua Dr. Diogo de Faria, 171, CEP: 04037-000, São Paulo, Brazil. e-mail: ppontes@inlar.com.br 408