The sound of your voice is made by the vibrations of your vocal folds which are positioned on either side of the larynx. When a person is not talking, the vocal cords are open, but when they are speaking the vocal cords snap together causing air from lungs to blow past, causing it to vibrate. The quality of our voice depends on the vibrations which are produced by the sound waves which travel through the mouth, throat and nose. This is what creates the uniqueness of a voice. If you have noticed a change in your voice and it feels hoarse, then an evaluation may be necessary if the symptoms have persisted for a few weeks.
Your voice plays an important role in life. It is the medium through which communication happens and the way ideas and emotions are expressed. Singers, teachers and speakers all depend on their voice to carry out their occupations. Hoarseness in the voice can happen due to many reasons. The ENT Clinic, an award winning medical practice in Singapore, can investigate the reason behind the hoarseness in your voice.
What are the causes for hoarseness in voice?
A temporary hoarseness in the voice can occur due to an upper respiratory tract illness such as a flu or cold or even due to overstraining of the voice. Causes include:
Laryngitis: This is due to an upper respiratory tract infection which is one of the most common causes of voice hoarseness. Laryngitis can result in temporary swelling of the vocal folds. Treating this upper respiratory tract infection with prescription drugs, fluids and rest will help to overcome laryngitis and subsequently the hoarseness in voice.
Gastroesophageal reflux (GERD): Hoarseness in the voice may be brought about due to GERD, when the stomach acid reaches the throat, causing tissue irritation. Individuals have a higher hoarseness in the morning, which improves through the day. For some individuals the acid can reach the vocal folds itself making an individual cough persistently. Antacids and dietary modifications can help to ease GERD.
Vocal cysts and nodules: Vocal nodules are hard masses of tissue which encase in the membrane of the vocal folds and this is very common in singers and generally called the ‘singer’s nodes’. These are benign and occur in pairs on either side of the vocal folds. The ENT doctor would advise voice therapy, rest or potentially surgery to remove the tissue.
Vocal fold haemorrhage: Hoarseness in the voice can occur when a blood vessel on the surface of the vocal fold ruptures causing the tissues to fill with blood. If you lose your voice suddenly then it can be due to this condition and it is important to have a complete voice rest. If the condition is not improving it is best to consult an otolaryngologist.
Vocal fold paralysis: This is when the vocal folds don’t open or close properly. This may occur due to head or neck trauma or due to an infection. In addition neurological conditions like Parkinson’s disease too can cause vocal fold paralysis.
Laryngeal cancer: A cancer in the larynx can also change your voice. This is the reason why hoarseness in voice should not be ignored. Hoarseness in voice which lasts for more than three weeks should be evaluated by an experienced medical practitioner.
When should I see an ENT doctor?
If you are not having a cold or flu and the hoarseness in your voice is persistent even after three weeks then, it is best to have an ENT consultation. Also if you are coughing up blood, or have difficulty breathing and swallowing or experiencing pain and discomfort in the neck region then it is important to meet with the specialist.
How is diagnosis being made?
Your doctor will conduct a thorough check by gathering your medical history. In addition, to understand the clinical symptoms, the doctor will want to have a better view of the vocal cords. For a confirmatory diagnosis more specialised tests would be recommended like laryngeal videostroboscopy. This test helps to identify if there are any issues with vocal airflow and evaluates for voice irregularities.
What is laryngeal videostroboscopy?
This is a non-invasive examination of the larynx which provides the ENT doctor with a slow motion, magnified view of the vocal cords in action. Through this technique the doctor can evaluate a number of vocal parameters and view to see if there are any irregular motions or other conditions in the larynx. An otolaryngologist would advise to perform a videostroboscopy if there is persistent laryngitis, hoarseness or any other vocal complaints. Through this examination, the doctor is able to check the vocal fold edges to identify if the edges are smooth or irregular. It helps to see the vocal fold closure to examine if the closing is complete or if there are gaps. Videostroboscopy helps to check on structural characteristics to see if there are any nodules or cysts or abnormal structures and how well vibration happens and if there is adequate pitch variation.
How the ENT Clinic Singapore helps Voice Professionals?
Professionals who rely on their voice have an increased risk of developing voice problems due to the nature of their employment. Keeping this in mind The ENT Clinic caters to such professionals. The highly trained ENT surgeons, voice therapists help with vocal recovery efficiently and effectively. Unlike most other medical practices, the ENT Clinic holds a licence to conduct videostroboscopy. Through this procedure, the doctors are able to detect the reason for the voice injury.
The Treatment Plan
Depending on the root cause for your hoarseness in voice, the ENT doctor will offer a personalised treatment plan for you. This includes:
- Education: The ENT doctor will educate you on self-awareness of your voice habits as well as voice conservation techniques with general voice care guidelines.
- Behavioural therapy: To rehabilitate the voice, therapists would help with voice exercises. In addition, you may be taught to allow ‘voice breaks’ throughout the day with non-verbal communication techniques.
- Medications: If the hoarseness in voice is due to conditions like GERD then antacids would help. The ENT doctor will treat allergies and any inflammation in the vocal cords using steroids like prednisone.
- Surgery: If tumours are detected then the ENT doctor will advise on surgery to remove it. In addition certain procedures may be needed if the usual rehabilitation procedures are not working like injecting of a substance to the larynx or an in-house laser treatment.
Contact the ENT Clinic to get a resolution to your ENT maladies from the otolaryngological team of Dr Jeeve Kanagalingam, Dr Annabelle Leong and Dr Chris Hobbs. The clinic specialises in both adult and pediatric ENT treatment and takes comprehensive care of its patients.