This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Voice and Speech Disorders, Subject name: ENT
A lady singer with singer's node with history of reflux, the best treatment is: 
Select and explain. 
A. Voice therapy and PPI, B. Microlaryngeal excision and PPI, C. LASER excision and PPI, D. Vocal cord stripping
A: Voice therapy and PPI
Answer: A: Voice therapy and PPI 
Explanation: (a) Voice therapy and PPI(Ref. Cummings, 6th ed., 906; Scott Brown, 8th ed., Vol 3; 951; 984)Initial management of vocal nodule is conservative by advising voice rest and speech therapy. Pharyngo-laryngeal reflux of acid is a common aggravating cause of most of the laryngeal pathologies, so PPI also will benefit this singer.Microlaryngeal excision with knife or LASER is done in persistent nodules despite speech therapyVocal cord stripping is done in keratosis laryngis/ leukoplakia and Reinke's oedema.