Changes in the voice are called "Hoarseness". When hoarse, the voice may sound breathy, raspy, strained, or show changes in volume or pitch (depending on how high or low the voice is). Voice changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx). While breathing, the vocal folds remain apart. When speaking or singing, they come together and, as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal folds hinder vibration, altering voice quality, volume, and pitch.
What are the causes?
- Acute Laryngitis
- Voice Misuse
- Benign Vocal Cord Lesions: nodules, polyps, cysts, etc
- Vocal Hemorrhage
- Gastroesophageal Reflux (GERD): when stomach acid comes up the swallowing tube (esophagus) and irritates the vocal folds
- Laryngopharyngeal Reflux (LPRD): If the reflux makes it all the way up through the upper sphincter and into the back of the throat, it is called LPRD rather than GERD
- Other Causes: allergies, thyroid problems and occasionally, menstruation. Very serious conditions such as laryngeal cancer can also cause hoarseness, which is why it is important to have chronic hoarseness evaluated promptly by an otolaryngologist.
How it is evaluated?
- Doctors usually look at the vocal folds either with a mirror placed in the back of the throat, or with a very small, lighted flexible tube (fiberoptic scope) that is passed through the nose to view the vocal folds. Videotaping or stroboscopy (slow-motion assessment) may also help with the analysis.
When should I see an Otolaryngologist?
- If hoarseness lasts longer than three weeks, especially if you smoke
- If you do not have a cold or flu
- If you are coughing up blood
- If you have difficulty swallowing
- If you feel a lump in the neck
- If you observe loss or severe changes in voice lasting longer than a few days
- If you experience pain when speaking or swallowing
- If difficulty breathing accompanies your voice change
- If your hoarseness interferes with your livelihood
- If you are a vocal performer and unable to perform
How are vocal disorders treated?
- The treatment of hoarseness depends on the cause. Many common causes of hoarseness can be treated simply by resting the voice or modifying how it is used.
- An otolaryngologist may make some recommendations about voice use behavior, refer the patient to other voice team members, and in some instances team of professionals who know and understand how the voice functions.
- These professionals are otolaryngologists, speech/language pathologists, and teachers of singing, acting, and public speaking. Vocal nodules, polyps, and cysts are typically treated with a combination of microsurgery and voice therapy.
How to prevent Hoarseness?
- If you smoke, quit
- Avoid agents that dehydrate the body, such as alcohol and caffeine
- Avoid secondhand smoke
- Stay hydrateddrink plenty of water
- Humidify your home
- Watch your diet, avoid spicy foods
- Try not to use your voice too long or too loudly
- Use a microphone if possible in situations where you need to project your voice
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