More About Voice Problems Including Hoarseness

From ENT-UK website

Hoarseness

Hoarseness is often used to describe a change to the voice. People suffering from hoarseness may experience a strained, raspy and/or breathy voice. People may also notice a difference in how loud they are able to speak and/or changes in how high or low their voice sounds (Pitch).

 What causes Hoarseness?

There are several causes of hoarseness, fortunately most are not serious and tend to go away after a short period of time. Hoarseness is a result of the vocal cords in the voice box (Larynx) not working properly. Normally when we talk/sing the vocal cords come together and vibrate. This creates a sound which we know as the voice. There are several reasons why the vocal cords may not be working correctly.

The most frequent are:

-An upper respiratory tract viral infection, which causes the voice box to swell ( Laryngitis).

-The build up of tissue (polyps) and or callous like growths (nodules) on the vocal cords. These can develop when the voice is used too much or too loudly for extended periods of time (Singer’s Nodules).

-The growth of tumours on the vocal cords and or voice box (larynx). These tumours are may be non cancerous (benign) or cancerous (malignant).

-Stomach acid irritating the vocal cords (Gastro-oesophageal Reflux).

How is Hoarseness treated?

Mild hoarseness

In most cases hoarseness will clear up on by itself. To help relieve the symptoms it may help to:

-rest the voice

-drink plenty of fluids

-avoid alcohol

-not smoke

-have bed rest

-take common painkillers e.g. Paracetamols or soluble aspirin

-take Antacids e.g Rennin, for hoarseness caused by the build up of excess stomach acid in the throat.

Severe or Recurrent Hoarseness

People suffering from the following symptoms should seek medical advice:

-prolonged hoarseness for over 3-4 weeks.

-repeated case of hoarseness without the symptoms of a viral infection or flu.

-prolonged sore throat or difficulty swallowing for more than two weeks.

-severe change in the sound of the voice which lasts for several weeks.

 

Medical examinations for horseness and laryngitis

Mr. Chisholm will examine the throat to identify the cause of the hoarseness. This is done by passing a flexible telescope to the back of the nose under local anaesthetic (Fibreoptic Endoscope).

Treatments for horseness and laryngitis

Depending on the clinical findings, the following treatment may be advised:

Speech Therapy: The majority of patients will have no structural abnormality identified. The problem with their voice will be related to the way that they are using their voice i.e. they are ‘straining’ it in some way. Under these circumstances the speech therapists will be able to advise exercises that might help the quality of the voice.

Microlaryngoscopy: An operation to remove nodules, polyps and non cancerous (benign) tumours may be recommended if these are identified in the outpatients. This type of operation is usually done under general anaesthetic using a rigid telescope (Endoscope) and a microscope (to provide magnification). It will remove the problem in the case of polyps, nodules etc. and will provide a piece of tissue to be looked at under the microscope (a biopsy) and hence make the diagnosis of cancer if the tumour is malignant. If a malignant tumour of the larynx is diagnosed by biopsy then the management options will include operations or radiotherapy.

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