VOICE


Like other tissues in the body, strain and damage can occur in vocal cords but they may not be visible until the problem becomes severe. People who use their voices extensively are at particular risk. This group includes lawyers, teachers, singers, cheerleaders, actors and clergy. People who work in noisy environments, such as airports or racetracks, are also at risk.

The general term used to describe any voice changes is hoarseness. This may include changes in voice quality, volume or pitch. Most causes of hoarseness are not serious and last for only a short period. Acute laryngitis is usually associated with the common cold, upper respiratory tract infection, or vocal abuse. The most dreaded cause of hoarseness in voice is a cancer of the larynx. Smoking and alcohol are major risk factors for cancer. Some systemic diseases can cause hoarseness such as laryngeal myxedema from hypothyroidism. Medications causing chronic cough can lead to voice changes. Postnasal drainage or gastro esophageal reflux disease or vocal nodules, can cause vocal abuse. Neurological disorders can cause vocal cord damage and also result in swallowing difficulty.

A vocal cord paralysis often results in a breathy voice. This can be caused by tumors of the skull base, neck and chest pressing on the nerve that controls vocal cord movement, viral infections, and vocal cord injury during surgery, blunt neck or chest trauma, and occasionally from endotracheal intubation.

CONDITIONS


Vocal cord dysfunction is a condition that affects the vocal folds, and is characterized by full or partial vocal fold closure that usually occurs during inhalation for short periods of time; this closure may cause airflow obstruction and rarely results in decreased oxygen saturation.

Symptoms can include shortness of breath, wheezing, dyspnea, coughing, tightness in the throat, skin discoloration due to oxygen deprivation, and loss of consciousness in severe cases. The symptoms of this syndrome can be inaccurately diagnosed as asthma, anaphylaxis, collapsed lungs, pulmonary embolism, or fat embolism, and may be harmful to the patient.

The primary treatment is to stop ongoing unnecessary treatment. The first line of treatment for VCD is speech therapy and would be adequate to correct the disorder. The steroids can be used only if there is underlying asthma. Some acute treatments can be include, intermittent positive pressure ventilation, Continuous positive airway pressure, and breathing exercise. The severe cases may require tracheotomy for temporary relief.
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