Hoarseness: What it means and what it hides

“Voice is the sound produced when exhaled air passes between the vocal cords and causes them to vibrate.

Each person has a particular and characteristic timbre of voice, which is shaped by a multitude of factors, such as the length, thickness, and tension of the vocal cords. These factors, together with the oral and nasal cavity, ultimately shape the sound, in articulate speech”, explains Mr. Christos Gionis, Director of Otorhinolaryngology at Metropolitan Hospital.

What is hoarseness?
The alteration of the voice which is caused by dysfunction of the larynx (alterations and problems of the vocal cords) or disorders in the closure of the vocal cords.
Hoarseness or hoarseness is a general term that describes any abnormal change in the voice.

Where does it come from and what are its causes?
It is due to visible abnormalities of the vocal cords such as:
• Acute inflammations/laryngitis (they are the most common cause of hoarseness and appear after acute microbial or viral infections of the respiratory system). Redness and swelling of the vocal cords are observed and these are acute conditions, which do not cause concern, last a few days and are very easily treated with specific instructions even if it is necessary, in some cases, to be assisted with the use of drugs.
• Chronic inflammations: Ranke’s edema (due to misuse of the voice-wrong speech and bad habits such as smoking and frequent alcohol consumption).
• Vocal cord polyps.
• Nodules of the vocal cords (the so-called calluses). These are nodules that appear in the middle of the vocal cords and are due to improper use of the voice (it is a frequent damage to voice professionals, such as: singers, actors, lawyers, priests, etc.).
• Allergic cough.
• GERD (gastro-oesophageal reflux): Here the hoarseness is accompanied by a feeling of a “lump” in the throat – granulomatous vocal cords.
• Precancerous lesions (eg leukoplakia, etc.).
• Malignant tumors.
• Paralysis of the vocal cords (unilateral or bilateral), due to lesions of the Central Nervous System, iatrogenic lesions after surgical operations or due to the presence of tumors pressing on the laryngeal nerve (the recurrent laryngeal nerve is a nerve related to the mobility of the vocal cords strings).
• Presbyphonia (atrophy of the chords due to age).
• Invisible damage to the vocal cords.
• Psychogenic conditions: Spasmodic dysphonia (anxiety and stress conditions significantly affect the larynx).
• Neuromuscular disorders: Parkinson’s disease, myasthenia gravis (treatment and treatment by a neurologist).
• Hormonal disorders such as hyper- and more often hypothyroidism. (Monitoring and treatment by an endocrinologist).

When is hoarseness a warning bell?
“It is very important to keep in mind that any hoarseness in the voice, accompanied by the feeling of needing to clear the throat, and lasting more than two or three weeks, especially if it involves smokers and/or people who drink too much alcohol, is a signal that needs to be checked by an otolaryngologist.

The coexistence of pain is not necessary and therefore let us not attribute chronic hoarseness to the simple habit of smoking. Negligence can be costly and put the patient in trouble,” the doctor points out.
Hemoptysis, shortness of breath, presence of swelling in the cervix, feeling of a knot or foreign body in the throat and sometimes pain that reflects in the ear, are symptoms that should lead to further investigation by the otorhinolaryngologist.

There is no simple hoarseness or hoarseness to which we should not pay attention, but this does not mean that we should be suspicious and afraid of all hoarseness, since as already pointed out, in the vast majority of them, these are benign. But the test is done to rule out with certainty, especially in smokers, any even the slightest possible malignancy.

How is the check done?
Checking hoarseness is a very simple procedure that consists of visiting an otolaryngologist in a doctor’s office or in an outpatient clinic of a hospital structure.

Most otorhinolaryngologists have modern tools such as high-definition endoscopes with a camera, which record high-resolution images, the study of which by the doctor, combined with his experience, allows the diagnosis to be made with great precision and the planning of the of any relevant treatment.

In cases where there are visible abnormalities of the larynx (polyps, nodules, cysts, malignancy, etc.), the treatment is surgical. In very mild impairments, the assistance of a speech therapist can be valuable.

The surgical procedure is called microlaryngoscopy and is performed under general anesthesia, with the use of a microscope, sophisticated endoscopes and special microsurgical tools, (or even the use of a laser).

Its purpose is to surgically remove the lesion (and take a biopsy) with precision, safety, and “respect” for the anatomical structures-particularities of the area, so as to achieve faster and better healing of the vocal cords and for the voice to return to normal as soon as possible. her normal state.

How can we protect our voice?
Through smooth pronunciation. Loud voices and whispering can damage the vocal cords.
Other ways to protect our voice are:
• Regular fluid intake
• Humidity in the home atmosphere
• Treatment of GERD
• Stop smoking
• Healthy diet
• Limiting the consumption of alcoholic and carbonated drinks and spicy foods.

“Voice professionals (educators, priests, singers, actors, lawyers, etc.) should visit their ENT regularly,” concludes Mr. Gionis.

Written by:

Mr. Christos Gionis, Director of Otorhinolaryngology at the Metropolitan Hospital

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