목적: The vc. nodules(VN) occur as a result of the abuse of the voice. The VN mostly occur at the midpoint of the vocal cords(vc.) and are mostly bilateral. Therefore, vc. gap is showed. However, the cause of VN is the controversy what is the result of the voice abuse or the bad habit of vocalization that bilateral vc. do not contact completely. There are a various voice therapy techniques introduced in the previous studies. But we need to apply different therapy depending on the size and other characteristics of the vc. In this study, we targeted the voice therapy of small sized VN. The purpose of this study was to investigate the effect of small sized VN voice therapy through the two different therapeutic approach to evaluate for effective treatment method. 방법: 40 women participated and VN size is small (1mm or less). All patients performed the vocal hygiene program in the 1st treatment. And then therapy protocol of group1 and 2 were as follows. Group1(reducing the strained voice and inducing soft glottal attack method) was given yawn sigh, confidential voice and the SKMVTT. Group2(reducing the breathy voice and inducing complete glottal attack method) was given Vocal Function Exercise, singing therapy. Before and after voice therapy, voice test, questionnaire and laryngeal examination were performed and we compared voice quality and vocal nodules size between two groups. 결과: Group2 showed 72% and group1 showed 41% VN size decreasing and group2 showed more complete glottic closure compared with group1. Group 2 showed lower values in voice test significantly compared with group1. Specially, acoustic and perceptual values lowed significantly even though VN remains slightly. 결론: We investigate breathy, asthenic voice and bad vocalization habits like incomplete glottic closure can cause VN too. Therefore, we suggest intensive voice therapy method inducing complete vc. gap is more effective therapy approaching. And bad vocalization habits correcting should be included in voice therapy.