What is hoarseness?
The hoarseness consists of an abnormal reproduction of the vocal timbre: the voice can be weak or husky, up to the temporary aphonia (inability to emit sounds).
If the symptoms are persistent or recurrent it is advisable to consult a specialist, as serious hoarseness also exists at the origin of hoarseness: the alteration of the voice can only be one of the symptoms of presentation of certain pathologies, such as allergic reactions, neoplastic lesions, neuromuscular changes and systemic diseases.
In summary: what disorders can cause hoarseness?
- Inflammatory processes affecting the larynx, both of infectious origin (colds, coughs, laryngitis, flu, bronchitis, etc.), and of chemical origin (example: inhalation of irritating substances such as dust, cigarette smoke, chemical vapors), both associated with allergic reactions;
- Benign neoplasms (example: polyps) or malignant neoplasms affecting the vocal cords (cancer of the larynx);
- Involvement of the nerves responsible for the vocal cord motility, due to expansive formations of the mediastinum or neck (eg goiter or neoplasms), or an accidental injury of these nerves during surgery.
Diagnosis
Hoarseness is a symptom common to many different diseases: it is important to distinguish the cases defined as "benign", from the most serious pathological conditions. The objective medical evaluation should consider the usual way in which the patient uses the voice and the possible subjective exposure to factors triggering the disorder. The doctor must collect the description of the symptomatology and, if necessary, provide adequate pharmacological support, as well as advise actions aimed at the causes, in order to obtain the remission of hoarseness.
The formulation of the diagnosis includes:
- Anamnesis (complete medical history of the patient) and the collection of information related to the symptomatology, to determine the cause of the alteration of the voice: the doctor can investigate about the quality and strength of the vocal timbre, in addition to the frequency and duration of symptoms. In this phase, it would be appropriate to highlight the factors that worsen the condition, such as smoking, shouting or talking for long periods, if you suffer from any allergies or if you have had a throat surgery. Your doctor may detect other symptoms, such as fever, cough, fatigue or weight loss.
- Physical examination, to look for any inflammation or alteration of the throat, neck, head and mouth.
Depending on the symptoms reported, the following diagnostic investigations can be performed:
- pharyngeal swab ;
- laryngoscopy : examination indicated in the case of laryngitis unrelated to causes of benign origin, allows direct vision of the larynx and allows a definitive diagnosis to be made;
- neck radiography or CT (computed tomography);
- blood count (complete laboratory test of the blood that allows to evaluate different hematological parameters).
Care
Identifying the causes of hoarseness makes it possible to solve most "benign" cases. The techniques for therapeutic intervention are not surgical, but involve behavioral re-education: the aim is to reduce and / or eliminate some factors favoring the disorder, with interventions on the environment, incorrect habits or possible primary traumas (to the larynx or throat) and secondary.
Medical therapy
Medical therapy depends on the determining cause of hoarseness: if the disorder is temporary, it is advisable to have vocal rest and possibly resort to anti-inflammatory drugs for sore throats and / or cough suppressants. In the acute phase of hoarseness it is essential to respect some rules to promote recovery: avoid shouting or speaking in an excessively high tone, not scraping one's throat, drinking plenty of fluids and stopping smoking.
Orthophonic therapy
Use of an orthophonic therapy allows the elimination of risk factors: a speech therapist can teach the patient the correct emission of the voice, in addition to indicating some coordination exercises between breathing and sound emission (the lack of coordination between the respiratory and phonatory moment, is the basis of a weakening of the vocal cord muscles).
Other therapeutic options
The most serious cases, which imply the presence of secondary alterations, foresee other therapeutic approaches: in case polyps or nodules were diagnosed, it is often necessary to intervene surgically to remove the neoformations, as these can represent a precancerous lesion (example: leukoplakia, a abnormal keratinization of the epithelium, which can potentially evolve into malignant neoplasia).
Prevention
There are several actions that can be taken to prevent hoarseness.
Listed below are some prevention methods that can help protect the vocal cords:
- Speak in a natural and medium tone of voice.
- Smoking cessation: smoking can cause irritation of the vocal cords and larynx, resulting in a dry throat sensation. Also avoid passive smoking.
- Wash your hands often. Hoarseness is often caused by a viral respiratory infection. Washing your hands prevents the spread of germs and helps maintain good health.
- Drink plenty of water to keep your throat moist. Avoid liquids that dehydrate the body such as caffeinated beverages and alcohol.
- Limit the urge to cough.
- If you suffer from gastroesophageal reflux: avoid acidic foods, reduce caffeine, do not lie down immediately after main meals and sleep with your head raised to avoid the return of acids to the esophagus.
Final considerations
The hoarse voice can be caused by a simple affection of the respiratory tract or be a consequence of abuse of the voice, but it can also be a symptom of a more serious pathology. In the case of chronic or recurrent hoarseness, do not underestimate or neglect the symptoms: these manifestations can be considered an alarm bell for decidedly more serious diseases, where identifying the specific cause means making an early diagnosis and multiplying the percentages of therapeutic success.
