Humans, being gregarious by nature, rely heavily on their voice for communication. Indeed, the ability to speak is what sets us apart from lower primates. ENT’s are trained to deal with the full gamut of voice problems.
To produce voice, your vocal cords (2 thin strips of tissue, or membranes) need to come together and vibrate smoothly and symmetrically as air passes over them. Any disruption or swelling of these cords will alter the sound produced. This could be a croaky voice, breathy, weak voice or just the occasional break in your voice, but the broad term for this is “hoarseness” or “hoarse voice”.
Many conditions can influence the quality of the voice, including polyps, cysts and nodules. The effect is not dissimilar to the change in quality of a musical instrument that is not tuned properly. Sometimes, something as simple as acid reflux from the stomach can cause inflammation of the cords, and thus alter the voice.
Smoking is unfortunately too common in our society. In addition to the disgusting social implications, smoking is a serious health hazard, both to the patient and their loved ones. Tobacco use in ANY form, including cigars and pipes, is a major risk factor for oral, throat and laryngeal cancer. Any change in voice in a smoker is regarded as cancer until proven otherwise, and the patient is investigated thoroughly to rule out cancer, including a flexible nasopharyngoscopy using a thin fibreoptic camera inserted (usually) through the nose.
The vocal folds are muscles, and, like muscles elsewhere in your body, can be fatigued if used excessively (many husbands might find this information useful…..) This will result in a strained quality of voice. Treatment is usually by simple voice rest.
In all voice conditions, the aid of a speech therapist usually results in the best outcomes.
The vocal cords consist of several layers of tissue, lined by a smooth mucosa on the outside. Overuse can occasionally cause a lump to form on this lining, similar to a callus on the skin from excessive friction, such as happens in menial labour. This lump is called a Singer’s Nodule, since it is commonly seen in singers.
Some of the symptoms of singer’s nodules include hoarseness, a decreased range, decreased colour or vibrancy of tone, vocal fatigue and throat discomfort. The excessive strain required to produce a “normal” voice may even result in neck pain.
Singer’s nodules looks like a whitish growth on the middle part of the vocal cords. Not all physicians have the ability to diagnose and treat singer’s nodules. That is why it is necessary to consult with an ENT surgeon who has the equipment, knowledge and expertise to accurately determine whether or not you have singer’s nodules.
Treatment for singer’s nodules usually starts off with voice rest and therapy from a skilled speech therapist. In extreme cases surgery can be offered, but the benefits and risks of this for a professional voice user will be explained by your surgeon.