Dysphonia: Disorder or inflammation of the vocal cords

The vocal chords They are two structures located in the larynx that are part of the speech apparatus of people and allow the voice to be produced. These are two folds that, when they come together, prevent the passage of air, which causes them to vibrate very quickly and produce the sound that we call voice. When, for whatever reason (infections, abuse or misuse of the voice, oncological pathology) the vocal cords are altered, what is called a vocal cord disorder occurs, which generally occurs in the form of dysphonia or alteration voice and whose treatment the otolaryngologist will be in charge of.

How the vocal cords become inflamed

Dysphonia presents as straining when making a sound, difficulty speaking, exhaustion while doing so, clearing the throat, or lack of volume. It is very common in adults, especially in women between the ages of 20 and 40. In those over 60 years the most common cause is presbyphonia or tired voice, while in voice professionals or teachers it is usually abuse or misuse of it, as well as in pediatric age.

Functional dysphonia occurs due to a lack of coordination between the vocal cords and the resonating organs. It occurs especially in teachers and voice professionals, due to the constant and sometimes forced or incorrect use of it.

Infectious diseases, or acute laryngotracheitis, mostly viral, are the most common cause of dysphonia. They usually last less than three weeks and respond adequately to symptomatic treatment. Laryngeal croup, a laryngotracheal inflammation associated with bronchitis, is common in children and is usually caused by viruses.

Chronic laryngitis is associated with the consumption of certain substances or exposure to irritants, such as tobacco, contaminated spaces, prolonged cough, recurrent infections, inhaled medications or gastroesophageal reflux.

Vocal nodules are the most common organic lesion that causes dysphonia. They are usually caused by vocal abuse or by infections, allergies or reflux. They are bilateral lesions that generally occur in the middle third of the vocal cords. Polyps, on the other hand, are usually unilateral lesions secondary to chronic irritation of the vocal cords. Reinke's edema is an inflammation that occurs in the vocal cords, generally due to tobacco or vocal abuse, due to the accumulation of mucous material.

It is also related to the consumption of tobacco and alcohol and has a higher prevalence among men. They are usually single, rough, ulcerated and infiltrating lesions that sometimes settle on premalignant lesions.

There are systemic diseases that can affect the vocal cords, such as amyloidosis, la, el, el or el. Likewise, there are neurological dysfunctions that can produce unilateral or bilateral vocal cord paralysis.

Symptoms

As has already been said, the main symptom of disorders of the vocal chords it is dysphonia, the alteration of the production of the voice. Depending on the cause, it may be accompanied by other symptoms, such as cough, mucus, pain when swallowing, low-grade fever, pain when speaking, runny nose, nasal obstruction, general malaise or fatigue.

Diagnosis

The diagnosis will be based on the patient's explanation of an alteration in his habitual voice, as well as the presence of other symptoms. It should be investigated if there is an associated disease, if you are a smoker or exposed to toxins and the patient's work history. It is also important to carry out a correct examination of the neck in search of masses such as goiter or laterocervical lymphadenopathy.

The cords should be visualized using one, either indirectly with a mirror, or directly through an endoscope, which will allow us to observe the vocal cords and the possible injuries or alterations present.

Depending on the suspected pathology, the study can be completed with blood tests, serologies, imaging tests such as computerized axial tomography (CT) or a study by the digestive system in case of suspecting gastroesophageal reflux.

Treatment of vocal cord disorders

Treatment will depend on the cause of the vocal cord disorder, generally combining various therapeutic approaches.

Vocal therapy

Vocal therapy, carried out by speech therapists and speech therapists, will consist of various measures and exercises of vocal hygiene that will allow the person to make correct use of their speech apparatus and not force the vocal cords when speaking. This treatment is usually useful for voice professionals and teachers, as well as for children with dysphonia due to poor use of the voice and in cases of presbyphonia, vocal nodules or Reinke's edema.

Medical treatment

Medical treatment will be based on the use of anti-inflammatory drugs, humidification and vocal rest. In case of infection with fever, apyretics and even antibiotics can be administered if it is a bacterial laryngitis (less frequent). Allergic laryngitis will be treated with antihistamines or corticosteroids if necessary, as well as in the case of severe laryngeal croup in children, which generally respond well to exposure to cold, humid air.

Surgical treatment

Surgical treatment will be performed when the cause of the dysphonia has been identified and it is not reversible simply with medical treatment or vocal therapy. This remedy is usually used in the case of congenital lesions, laryngeal polyps, Reinke's edema or presbyphonia without response to conservative treatment, and of course in the case of malignant tumors of the vocal cords. In some tumors, radiation therapy can be curative and can be used as a single treatment or associated with surgery and / or chemotherapy.

Precautionary measures

The main preventive measures to avoid vocal cord disorders are to use your voice correctly, without straining it too much or yelling excessively, as well as avoiding exposure to harmful substances such as tobacco smoke.

Faced with dysphonia that does not subside in a few days, it is important to put yourself in the hands of the otolaryngologist.

It is very important to go to a specialist doctor if vocal cord disorders are recurrent and for this, the best solution is to be supported by the one with the most complete coverage and the most experienced professionals.

WHAT YOU SHOULD KNOW

• Vocal cord disorder presents in the form of dysphonia or alteration of the voice.
• It is very common in adults, especially in women between the ages of 20 and 40.
• Dysphonia presents as straining when making a sound, difficulty speaking, exhaustion while doing so, clearing the throat, or lack of volume.