HOARSENESS. Prevention and types of treatment

Transcription

1 HOARSENESS Prevention and types of treatment What is hoarseness? What are the causes of hoarseness? How is hoarseness evaluated? When do I need to seek specialized medical evaluation? What are the treatments for vocal disorders? What can I do in order to prevent and treat hoarseness?

2 WHAT IS HOARSENESS? Hoarseness is the term employed to describe abnormal changes in the voice, which can be in quality (when it sounds breathy, raspy or husky) and in intensity. These changes occur as a result of structural or nonstructural alterations. The former include nodules, polyps, cists or tumors; the latter include neurological (e.g. paralysis) or functional (caused by the use of certain types of medication, voice misuse, etc) alterations on the vocal folds. WHAT ARE THE CAUSES OF HOARSENESS? There are many risk factors for hoarseness. Inflammatory and infectious processes, which usually last for less than 10 days, are some of them. Structural alterations persist for as long as the lesions on the vocal folds are present. Vocal misuse, nodules, cists or polyps are risk factors associated with long-lasting hoarseness in adults. Vocal nodules are more frequent in children than in adults, as the first group uses the voice in playing activities. In adults, gastroesophageal reflux can be a cause of hoarseness. These patients present hawk, dry cough, the feeling of having a lump in the throat, and other symptoms. Gastroesophageal reflux has been considered a risk factor for larynx cancer¹. In addition, it has been recently

3 described as a cause of deterioration of vocal quality and of diminished phonation capacity². Other risk factors such as smoking, alcoholism and antioxidant vitamins deficiency have also been associated with vocal alterations and, especially, with larynx cancer³. 1 Laryngoscope, 101 (4Pt 2 Suppl 53): 1-78, April J. Voice, 20(1): , March Revista Amrigs, 48(4): , Dez HOW IS HOARSENESS EVALUATED? Medical evaluation takes into account the symptoms described by the patient and includes ear, nose and throat examination. Laryngeal endoscopy (with or without video recording), is a useful tool in differentiating lesions in the vocal folds. The procedure is well tolerated by patients of all ages and there is no need of hospitalization.

4 WHEN DO I NEED TO SEEK SPECIALIZED MEDICAL EVALUATION? When the hoarseness persists for more than 2 weeks or when it is associated with: - Pain or burning in the throat that is not related to common cold; - Coughing up of blood; - Difficulty in swallowing; - Presence of lumps in the neck; - Breathing difficulties; - Hawk or feeling of having a lump in the throat. WHAT ARE THE TREATMENTS FOR VOCAL DISORDERS? The treatment of choice will depend on the cause. In many cases, hoarseness is treated with medication, vocal rest or changes in vocal habits, which can be achieved by speech therapy. Surgical intervention is restricted to cases of structural lesions on the vocal folds and of neurological lesions in the larynx; in these cases, speech therapy is also part of the treatment. Larynx hydration is essential, especially for professional voice users.

5 WHAT CAN I DO TO PREVENT AND TREAT MY HOARSENESS? - Avoid dehydrating agents, such as alcohol and caffeine; - Avoid smoking; - Drink water according to the recommended daily amounts; - Avoid excessively cold environments (air conditioner); - Avoid spicy foods; - Professional voice users: use the voice moderately (restrict the time period); - Avoid speaking or singing when your voice is hoarse or with other alterations. LINKS: - Journal of Voice: - Pacific Voice Speech Foundation: - Estill Voice International: - Brazilian Otorhinolaryngology Foundation: