Picture of bilateral vocal cord nodules (teacher's / singer's / preacher's nodules). As these names imply, vocal nodules are caused by voice abuse and produce a hoarse breathy voice. These lesions are benign. They are bilateral and face each other. They grow at the junction of the anterior and middle thirds of the vocal cords. Occasionally, a small capillary ruptures inside the nodule and makes it look red (hemorrhagic nodule).