Throat And Voice
Jason Hamilton (Facial Plastic & Reconstructive Surgeon) gives expert video advice on: How do I know if I have a voice problem?; What is the treatment for vocal chord lesions? and more...
What are the possible causes of my voice problem?
Most typically voice problems are due to overuse or straining the voice, like a singer who is over singing, or a teacher or a coach who is yelling all the time and using their voice in a strenuous manner. Other problems that can occur with the voice are chronic hoarseness and that can be caused from smoking, chronic alcohol use or working in environments where there's a lot of irritants like in a chemical factory or a mine or something of that nature. Reflux or heartburn can also cause problems with the voice. The mechanism for this is that acid from the stomach chronically is coming up and actually dropping on top of the vocal chords and burning them, and over time, it causes inflammation and swallowing it can lead to hoarseness. The most common symptom of reflux is, actually, hoarseness. It's not the burning sensation that you feel in the stomach or the chest. Typically, patients may not associate the two with one another. If you're hoarse, many times the otolaryngologist will give you a diagnosis of reflux disease and treat you with antacid.
What is "laryngitis"?
Laryngitis is a viral infection which causes difficulty swallowing,fever, and throat pain just to name a few. Laryngitis is caused by smoking or prolonged vocal abuse.
When should I see a doctor about voice problems?
Typically you should seek help from a laryngologist if you've had any change in your voice for more than a two week period. Any prolonged hoarseness that hasn't been evaluated could be a sign of cancer or a serious disease that could easily be treated, but you must come in for an examination to evaluate it.
What are "vocal chord lesions"?
Vocal cord lesions is a broad category, and it encompasses benign conditions such as polyps or simple nodules that are caused from overuse of the voice, to cancers or infections by viruses, which cause ulcerations of the vocal cord. The reason the otolaryngologist terms them as a lesion is because it's almost impossible to tell from an examination with the eye what type of lesion we're dealing with, whether it be benign or cancerous. So typically, you'll be taken for a biopsy, and once a biopsy is done of that lesion, a diagnosis will be returned and we'll be able to categorize it as either being benign or cancerous.
What are "polyps" and "nodules"?
Vocal nodules are benign. They're small swellings on the vocal cords, and they're usually caused from overuse of the voice. The vocal cords work by vibration, and by straining the voice, the cords actually beat against one another vigorously and form almost callouses, like you'd form on your hands, on the vocal cords. Typically, with rest and voice training, these nodules can subside on their own. If they don't subside, they can be removed surgically. Polyps are very similar to nodules and are typically caused by either vocal abuse or from smoking, and they again can be removed surgically, or they can improve with voice rest and voice training as well.
What is the treatment for vocal chord lesions?
Vocal chord lesions can be treated medically or surgically. And the medical treatment involves voice rest and vocal training. Vocal training is done by a speech therapist who evaluates what habits you're doing in your daily life that are causing you to develop these lesions like nodules or polyps. By correcting those actions, for example, if you're a coach and you're yelling all the time maybe they'll tell you to use a microphone. Those can help relieve the symptoms as well as cause the nodules or the polyps to subside and kind of resolve completely. If, with this voice therapy, the nodules or polyps don't resolve, then you may need surgery to remove them physically to improve your voice. Typically no matter what type of lesion you have on your vocal chord, you will get a biopsy to kind of rule out if there's a cancer underlying them.