Is your voice hoarse? Learn about vocal cord lesions

Do you also often feel a change in your voice, a hoarseness? Maybe you are a teacher, a lecturer, a singer. Or maybe you are someone who has to talk all day at work. Sometimes after watching a cricket match and shouting loudly, when you wake up the next morning, your voice is gone? We think these things are normal, but if this situation continues, the reason for it may be small bumps on your vocal cords. Don't worry, we will talk about everything in a simple and friendly way today.

What are these vocal cord lesions?

Simply put, these are small lumps, cysts, or vesicles that form on our vocal cords. Some of these can be benign (non-cancerous) and some can be malignant (cancerous). However, in this article, we will mainly talk about non-cancerous lumps .

Imagine, inside our throat, specifically in the part called the larynx, there are two small muscle bands. Just like two strings on a guitar. These are what we call the vocal cords . When we speak, when we sing, these two vocal cords vibrate together. That vibration is what produces sound.

So, if there's a lump on these vocal cords, that vibration doesn't happen properly. That's when our voice changes, it becomes hoarse, and sometimes it starts to be painful to speak.

Are there any types of these lumps?

Yes, we are talking about three main types of non-cancerous lumps. They are Nodules, Polyps, and Cysts. Let's take a look at what each of these are.

What symptoms do these lumps cause?

The most common symptom is hoarseness , but symptoms can vary depending on the size and shape of the lump, and how much it interferes with the function of the vocal cords.

Here are the things you need to be careful about:

• Hoarseness of voice: A voice that is not clear and sounds raspy when speaking.
• Breathiness: The feeling of air escaping with the voice when speaking.
• Vocal fatigue: A sore throat and a feeling of losing your voice even after speaking for a short time.
• Loss of voice: Complete loss of voice or a very low pitch.
• Loss of vocal range: If you are a singer, you may not be able to reach the higher or lower notes you used to.
• Voice cracking: The voice suddenly cracks while speaking.
• Frequent throat clearing: You feel like you have something stuck in your throat, so you constantly feel like clearing your throat.
• Neck pain: Sometimes you may experience neck pain or a stabbing pain that goes from ear to ear.

Why do these lumps form? What are the main causes?

As we discussed earlier, the main cause of nodules and polyps is excessive or incorrect use of the voice over a long period of time. Imagine that you are a teacher who shouts and teaches for hours every day. Then the vocal cords are constantly rubbing together, getting injured, and over time, nodules can form in those areas.

Here are some other causes and risk factors that contribute to the formation of these lumps:

• Smoking: Smoking is the biggest cause of damage to the vocal cords. It greatly increases the risk of vocal cord swelling and the formation of nodules.
• Having frequent sinus problems (sinusitis): Frequent throat clearing due to things like nasal congestion and mucus can damage the vocal cords.
• Allergies: Allergic conditions can also cause the vocal cords to swell.
• Hypothyroidism: This condition can also affect the vocal cords due to swelling of the body's tissues.
• Chronic acid reflux (GERD): A common problem for many people is gastritis. This is when the stomach's acidic contents flow up into the throat. These acids can irritate and damage the vocal cords, causing them to swell and become sore.
• Excessive alcohol and caffeine (tea, coffee): These dehydrate the body. This means that the vocal cords lose moisture, making them dry and susceptible to damage.
• Speaking when you have an illness like a cold: Using your voice when you have a throat infection can cause significant damage to your vocal cords.

How does a doctor diagnose this condition?

When you see a doctor, especially an ENT surgeon, with a voice problem, he will first ask you questions. What is your occupation, how long do you talk, do you smoke, and do you have gastritis?

Then, several special tests are performed to examine the vocal cords.

• Laryngoscopy: In this procedure, a thin, flexible tube (scope) is passed through your nose and into your throat. The tube has a small camera and light on the end. This allows the doctor to see your vocal cords clearly on a monitor. Although this may feel a little uncomfortable, it is usually not painful.
• Stroboscopy: This is similar to laryngoscopy. However, the light used in this is special. It is a strobe light that flashes and goes off at the same rate as the vocal cords vibrate. This allows the doctor to see the pattern of vocal cord vibration in slow motion. This is the best test to accurately assess the function of the vocal cords.

What are the treatments for this?

The best part is, most of the time these lumps don't require surgery. There are several treatment options.

1. Voice Therapy: This is the main and most important treatment. This is done by a Speech-Language Pathologist. Here you will be taught how to use your voice correctly and without damaging your vocal cords. You can learn many things through this, such as how to breathe properly and how to speak without straining your throat. This treatment is especially effective for nodules.

2. Lifestyle Changes (Behavioral Modifications):

• If you smoke, stop it completely.
• Reducing stress.
• Changes in eating habits (e.g., eating the right foods if you have gastritis).

3. Treatment of underlying diseases:

• If you have gastritis (GERD), allergies, or sinus problems, it's important to get them treated properly. Otherwise, just practicing your voice may not help.

4. Surgery:

• Surgery may be required for nodules that do not heal with things like voice training, as well as polyps and cysts. Polyps and cysts usually do not go away with voice training alone.
• Even after surgery, it is very important to receive voice therapy to prevent these problems from recurring.

Can't these lumps be prevented from forming?

Of course you can. Our voice is our most valuable asset. We should be interested in protecting it. Here are some simple tips:

Good things to do:

• Drink plenty of water: Drink at least 2-3 liters of water a day. This will provide the necessary moisture to the vocal cords.
• Give your voice a break: If someone else is going to continue talking, take a break in between. Don't talk.
• Sleep well: Rest is essential for the body as well as the voice.
• Use a microphone: If you are speaking to a large group, use a microphone instead of shouting.
• Warm up before speaking/singing: Like singers, it's a good idea for teachers to warm up their throats a bit before starting the day.
• Use a humidifier: If the room you are in is very dry (where AC is used), it is a good idea to add moisture to the air with a humidifier.

Things to avoid:

• Screaming and talking loudly when you have an illness like a cold.
• Smoking and hanging around people who smoke.
• Excessive alcohol and caffeine intake.
• Frequent throat clearing: Take a sip of water instead.
• Whispering: Many people think that whispering is good for the voice. But that's wrong. Whispering actually puts more strain on the vocal cords.

Hoarseness, Vocal Cord, Vocal Cord Nodules, Vocal Cord Polyps, Hoarseness, Voice Therapy, ENT Sri Lanka