Ear, Nose & Throat Care
By Dr Rekha Balachandran
Losing one’s voice is not an uncommon complaint. The voice becomes progressively raspy and breathy in nature. Is this something to worry about? What can we do to treat this? Read on and find out!
What’s the cause?
Most of the time the causes of this voice change or hoarseness isn’t serious and is self-limiting in nature. Voice is produced by the vibration of the vocal cords. When we talk or sing the vocal cords come together and vibrate. When there is any change in the structure or movement of the vocal cords, it results in a change of voice.
The commonest causes for hoarseness are:
- An upper respiratory tract infection usually, which causes the voice box to become inflamed (aka Laryngitis).
- People who need to use their voice loudly for prolonged periods of time like teachers and singers develop scar tissue or nodules called Singer’s nodules on the vocal cords.
- Acid reflux from the stomach (GERD).
- Tumours of the vocal cord which can be either benign or cancerous.
How do we manage it?
Hoarseness that occurs during or after an upper respiratory infection is often self-limiting and the voice should return to its normal tone is a few days. This can be helped by:
- Voice rest. This is the single most important thing to do. Patients are advised to refrain from talking as much as possible. No whispering either as it usually worsens the hoarseness as it puts more strain on the vocal cords.
- Drinking plenty of fluids.
- Avoiding cigarettes and alcohol.
- Avoiding acidic foods and fruits especially.
- Taking a soft soothing diet and avoiding extreme temperature of foods and drinks.
When do we seek medical help?
If someone has any of the following symptoms they should seek advice from an ENT doctor:
- Any hoarseness or change in voice for longer than 3 weeks.
- Repeated episodes of hoarseness that occurs without any preceding upper respiratory tract infection.
- Any associated difficulty or pain during swallowing with the hoarseness.
- Whistling sound or any noisy sound during breathing.
How are the vocal cords examined?
The voice box or larynx is examined using a scope which is introduced either via the mouth or the nose. This is a simple, office based procedure done using local anaesthetic.
How is it treated?
If there is no structural abnormality or growth in the vocal cords, majority are treated with voice rest and sometimes prescribed speech therapy. The speech therapist will help to educate on how to use your voice without straining it too much.
If there are growths on the vocal cord these need to be treated with surgery. Nodules, cysts and polyps of the vocal cord can be removed using endoscopic devices without any neck incision or scars. These are done under general anaesthesia. If the growth is cancerous, more extensive surgery may be required and in some cases the entire larynx may need to be removed.
