Hoarseness of voice

The human voice is sound waves that occur during the passage of air through the glottis with closed ligaments. The timbre of the voice changes depending on the development of the ligaments, if they are long and thick, then the voice is lower, with even ones it is cleaner.

Hoarseness and lowering of the voice occur with uneven and thick ligaments. It also happens when there are other obstacles blocking the path of the sound wave. In medicine, this has its own term dysphonia.

Reasons for voice change

There are many different reasons that can affect the change in the timbre of the voice. Inflammation of the ligaments of an infectious nature (laryngitis), this also applies to the larynx – with such diseases, violations of the structure of the ligaments occur. This is swelling in inflammatory processes, causing hoarseness. It does not allow the ligaments to close completely, because of this, the sound decreases.

Dry cough with tracheitis, high fever, tickling and tickling: with severe hoarseness, the voice may disappear completely, in other words, aphonia will occur. This most often occurs during the flu, adenovirus infection and other pathologies.

In addition, against the background of thrush of the oral mucosa, the development of laryngitis is possible. If this condition becomes chronic, then hoarseness is not treatable.

Intoxication of the body: for example, when chlorine vapor is inhaled, the glottis closes and a cough appears, with a possible complete short-term loss of voice. When ammonia poisoning develops hoarseness, perspiration, chest pain, “wet” cough. In advanced situations, these conditions cause pulmonary edema. Fluorine provokes the symptoms of laryngitis and nasal discharge begins, tears flow in a “hail”, cough, diarrhea mixed with blood, convulsions and even delirium.

Allergy: manifested by Quincke’s edema – this is a rather serious condition that can be fatal. Hoarseness in this case is a serious symptom, which indicates a spasm of the larynx and leads to suffocation. In addition, itching and coughing appear, it is difficult for a person to breathe, the skin turns pale, the fingers and face become bluish, lethargy appears, and then loss of consciousness. All these symptoms quickly pass from one to another, so this condition is urgent. In other words, the patient needs to urgently call an ambulance.

Metabolic disorders: when the thyroid gland does not produce the required amount of hormones, this can also affect the change in voice. Violation of the production of hormones occurs after the surgical removal of the gland due to a neoplasm or goiter. This is affected by radiation therapy or lack of iodine in the body. In case of violations of the thyroid gland, fluid retention occurs, and the mucous membrane of the larynx gradually swells. The swelling in this case is difficult to treat, although the voice can be restored with hormonal treatment.

Symptoms of a lack of thyroid hormones:

• edema;
• retardation;
• pallor and dryness of the skin;
• brittle hair;
• refusal to eat;
• dyspnea;
• slowing of the heartbeat.

Dehydration: Lack of fluid in the body can cause hoarseness. In this case, dryness of the mucous membrane and skin, a hoarse voice appear. Later, irregular heart rhythms and confusion are added to these symptoms.

Great strain on the ligaments: this applies to teachers, actors, singers whose ligament tension is chronic (and they may lose their voice). To avoid the occurrence of such a condition, they are engaged in special programs and regularly undergo examinations at the phonator. For example, an unprepared person after a long and strong cry can become hoarse and even completely lose his voice for an indefinite time.

Traumatic ligament injury: often occurs during tracheotomy. This is a condition in which the trachea is cut. However, at present, this operation is not performed, it was replaced by a conicotomy, in which the ligament between the thyroid and cricoid cartilages is dissected. You can also get damaged during surgery on the thyroid gland (the voice remains hoarse forever).

In addition, the laryngeal mucosa is damaged after tracheal intubation. The patient’s voice will be restored after the wound heals.

Neoplasms of the larynx: tumors in the process of their development increase and begin to put pressure on blood vessels, nerves, because of them the mobility and structure of the vocal cords are disturbed. Benign neoplasms are congenital or acquired in nature (more often they are diagnosed in men). Patients complain of hoarseness, in addition, they periodically cough. The tumor, which has a leg, episodically changes the voice, if the neoplasm prevents the vocal cords from closing completely, then the sound disappears completely. Tumors that are too large cause suffocation.

Malignant processes in the larynx change the voice in the early stages of development. However, this happens if the area of ​​​​their localization is the vocal cords. When they are located elsewhere in the larynx, then the loss of voice will occur later (hoarseness will be permanent). With the further development of the pathology, the patient will experience pain in the throat, which will eventually become chronic. At a later date, exhaustion and cancerous intoxication of the body will appear.

Hoarseness in a child

In children, this condition can occur for the same reasons as in an adult. But there are also some peculiarities:

• cysts formed in the throat (congenital);
• papillomatosis;
• foreign objects (often, when examining a child’s larynx, doctors find seed husks and even small toys);
• cry (frequent and prolonged cry will “plant” the voice, every day the condition of the ligaments worsens, nodules appear on them, which cause hoarseness).

If no anatomical changes in the larynx are found that could lead to a deterioration in the voice, then the baby should be shown to the phoniatrist (in this case, functional dysphonia appears).

Separately, it should be said about the transitional age of boys – their hoarseness appears at about 15 years old, when the hormonal balance changes and the vocal cords lengthen. If the transformation of the voice lasts more than six months, then the teenager should be examined by a qualified specialist.

All the above states are planned, but sometimes there are urgent cases in which it is necessary to act quickly, clearly and competently so as not to lose precious time. This, as already mentioned, Quincke’s edema or stenosis of the larynx – a sharp narrowing of the throat. In children, this phenomenon can happen even at the first contact with the allergen (the mucous membrane begins to swell, the glottis narrows, the ligaments become thicker).

Stenosing laryngotracheitis of an infectious nature: most often it is diagnosed in young children under three years of age). Against the background of the flu, the larynx begins to swell below the glottis. This can happen due to diphtheria or herpes infection (there is evidence of stenosing laryngotracheitis during chickenpox).

Attacks mainly occur at night: the child develops a hoarse cough, hoarseness and complete loss of voice. Before complete asphyxia, long and noisy breaths occur, the skin is pale, the fingers and the nasolabial triangle become cyanotic.

There are several degrees of stenosis:

1. First degree: characterized by lack of air only during exercise.
2. Second degree: the skin turns pale, the lips and tip of the nose turn blue, the heartbeat becomes frequent, the child’s behavior is characterized as excited (for breathing, the baby attracts other muscle groups).
3. Third degree: in this case, the difficulty in breathing becomes quite pronounced, the breath is heavy, the breathing is noisy, the skin is pale, the fingers and lips are blue.
4. Fourth degree: in medicine this includes suffocation with shallow breathing, slow heartbeat, lethargy, fainting and lethargy.

Therapy strengthened

Two doctors are involved in the treatment of a hoarse voice – this is an ENT (otolaryngologist) and a phoniatrist. The first one treats pathologies of the larynx, and the second one eliminates voice problems. To restore the voice, the patient must be silent, this is the most important thing. In this case, “silence” can be assigned to different time periods. Stenosis of the larynx, when it has an infectious or allergic cause, is treated by emergency doctors, as well as intensive care anesthesiologists.

Etiotropic treatment is used in the presence of an infectious pathology: in case of a virus infection, antiviral agents are prescribed, in case of bacteria, broad-spectrum antibiotics are used, in case of fungi, antifungal and antihistamine drugs are used to reduce laryngeal edema.

Ascorbic acid is also considered a good remedy for hoarseness, for this a 5% solution is used.

An allergic lesion of the larynx should be treated in this way: urgently protect the patient from contact with the allergen, inhale oxygen, administer drugs intravenously and, if necessary, intubate the trachea. If it does not help, artificial ventilation of the lungs is carried out and the patient is hospitalized.

After, the patient is determined in the intensive care unit or intensive care unit. Then they are transferred to the profile, depending on the reason that influenced the development of this condition.

Allergy is treated with infusion therapy using antihistamines and glucocorticosteroids. Cysts, neoplasms and papillomatosis are excised during surgical interventions. Vascular diseases are eliminated during the operation or directly from a vascular surgeon. Hemorrhages in the brain are treated according to the type of stroke in the neurological department (neuroinfections and bulbar palsy are also removed). With peripheral paresis of the nerves of the larynx, it is necessary to identify the underlying disease that led to this. In the process of rehabilitation, physiotherapy and phonopedic classes are prescribed. In case of chlorine intoxication, rinse the nose, eyes, mouth, then carry out oxygen inhalation and introduce analeptics. In case of ammonia damage, inhalation is carried out with warm steam with vinegar and citric acid. In case of fluorine poisoning, the stomach is washed, calcium is taken and a glass of milk is drunk with the addition of two egg whites.

For the treatment of hoarseness, not only a solution of ascorbic acid is used, but also lozenges. However, they have a main contraindication – this is the age of up to 5 years. Therefore, doctors often prescribe 2nd and 3rd generation antihistamines, as well as antiseptics. Local antiseptics are considered: preparations based on iodine; chlorine-containing products; vegetable absorbable lozenges; inhalation formulations.

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