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Most changes in the voice result from a medical disorderFailure to seek a physician’s care can lead to hoarseness and more serious problems.

What is Laryngitis?

Laryngitis is a swelling of the vocal cords usually due to an infectionA viral infection (a “cold”) of the upper respiratory track is the most common cause for infection of the voice boxWhen the vocal cords swell in sizethey vibrate differentlyleading to hoarsenessThe best treatment for this condition is to rest or reduce your voice use and stay well hydratedSince most of these infections are caused by a virusantibiotics are not effectiveIt is important to be cautious with your voice during an episode of laryngitisbecause the swelling of the vocal cords increases the risk for serious injury such as blood in the vocal cords or formation of vocal cord nodulespolypor cysts.

Vocal Cord Lesions

Benign noncancerous growths on the vocal cords are caused by voice misuse or overuse and from trauma or injury to the vocal cordsThese lesions (“bumps”) on the vocal cord(s) alter vocal cord vibrationThis abnormal vibration results in hoarseness and a chronic change in one’s voice qualityincluding roughnessraspinessand an increased effort to talk.

The most common vocal cord lesions include vocal nodules also known as “singer’s nodes” or “nodes” which are similar to “calluses” of the vocal cordsThey typically occur on both vocal cords opposite each otherThese lesions are usually treated with voice rest and speech therapy (to improve the speaking technique thus removing the trauma on the vocal cords)Vocal cord polyp(s) or cyst(s) are other common vocal cord lesions caused by misuseoveruseor trauma to the vocal cords and frequently require surgical removal after all nonsurgical treatment options (i.e., speech therapy) have failed.

Gastroesophageal & Laryngopharyngeal Reflux Disease

Reflux (backflow of gastric contents) into the throat of stomach acid can cause a variety of symptoms in the esophagus (swallowing tube) as well as in the throatHoarseness (chronic or intermittent)swallowing problemsa foreign body sensationor throat pain are common symptoms of gastric acid irritation of the throatcalled laryngopharyngeal reflux disease (LPRD)LPRD is difficult to diagnose because approximately half of the patients with this disorder have no heartburn symptoms which traditionally accompany gastroesophageal reflux disease (GERD).

Your gastric acid can flow up to the throat at any timeThe at-night aspect of LPRD is thought to be the hardest to diagnose because there are usually no specific symptoms while the reflux occursConsequentlypatients will awake with throat irritationhoarsenessand throat discomfort without knowing the causeAn examination of the throat by one of our ENT physicians will determine if stomach acid is causing irritation of the throat and voice box.

Poor Speaking Technique

Improper or poor speaking technique is caused from speaking at an abnormally or uncomfortable pitcheither too high or too lowand leads to hoarseness and a variety of other voice problemsExamples of this condition are when young adult femalesin a work environmentconsciously or subconsciously choose to speak at a lower than appropriate pitch and with a heavy voicePercussive speakinga voice too loud or focusing on the first syllable of each wordis another improper speaking technique that may result in injury or trauma to the vocal cords and muscles causing “vocal fatigue”.

Other factors leading to improper speaking technique include insufficient or improper breathing while talkingspecifically breathing from the shoulders or neck area instead of from the lower chest or abdominal areaThe consequence of this practice is increased tension in the throat and neck muscleswhich can cause hoarseness and a variety of symptomsespecially pain and fatigue associated with talkingVoice problems can also occur from using your voice in an unnatural positionsuch as talking on the phone cradled to your shoulderThis requires excessive tension in the neck and laryngeal muscleswhich changes the speaking technique and may result in a voice problem.

Vocal Cord Paralysis

Hoarseness and other problems can occur related to problems between the nerves and muscles within the voice box or larynxThe most common condition is a paralysis or weakness of one or both vocal cordsInvolvement of both vocal cords is rare and is usually manifested by noisy breathing or difficulty getting enough air while breathing or talkingHoweverone vocal cord can become paralyzed or severely weakened (paresis) after a viral infection of the throatafter surgery in the neck or cheekor for unknown reasons.

The immobile or paralyzed vocal cord typically causes a softbreathyweak voice due to poor vocal cord closureMost paralyzed vocal cords will recover on their own within several monthsThere is a possibility that the paralysis may become permanentwhich may require surgical treatmentSurgery for unilateral vocal cord paralysis involves positioning of the vocal cord to improve the vibration of the paralyzed vocal cord with the non-paralyzed vocal cordThere are a variety of surgical techniques used to reposition the vocal cordSometimes speech therapy may be used before or after surgical treatment of the paralyzed vocal cords or sometimes as the sole treatmentTreatment choices depend on the nature of the vocal cord paralysis as well as the patient’s voice demands.

Throat Cancer

Throat cancer is a very serious condition requiring immediate medical attentionWhen cancer attacks the vocal cordsthe voice changes in qualityassuming the characteristics of chronic hoarsenessroughnessor raspinessThese symptoms occur at an early stage in the development of the cancerIt is important to remember that prompt attention to changes in the voice facilitate early diagnosisthus early and successful treatment of vocal cord cancer can be obtained.

Persistent hoarseness or change in the voice for longer than two to four weeks in a smoker should prompt evaluation by one of our ENT physicians to determine if there is cancer of the larynx (voice box)Different treatment options for this cancer of the voice box include surgeryradiation therapyand/or chemotherapyWhen vocal cord cancer is found earlytypically only surgery or radiation therapy is requiredand the cure rate is high (greater than 90 percent).

Hoarseness or roughness in your voice is often caused by a medical problemContact one of our ENT physicians if you have any sustained changes to your voice.

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