what are dysphonias, symptoms, causes and what therapies we have available – breaking latest news

Voice alterations, or in medical terms hoarseness, are very common. Some categories of workers know this well, such as teachers and call center staff. The sound of the voice comes from the vocal cords, very specialized vibrating structures to be used appropriately.

The most common causes of hoarseness

“In most cases, dysphonia depends on a dysfunctional or structural alteration of the vocal cords – he says Joan Cantarella, head of the Phoniatrics Service at the Otorhinolaryngology Complex Operational Unit of the Irccs Policlinico of Milan —. A typical cause is viral infections of the upper respiratory tract, such as laryngitis. These cause an inflammatory state (oedema) of the cords and therefore a temporary alteration of their microstructure which is no longer able to function adequately. The mistake we all make in this situation is to aggravate the situation by continuing to use our voice. While the first thing to do would be to keep the vocal cords at rest. Overuse of the voice is another common cause of hoarseness. This typically happens in situations where for professional reasons the voice is used continuously, without adequate rest breaks, and above all at too high a volume. Ambient noise too it can be the cause of vocal fatigue: it reflexively leads to turning up the volume».

The factors that favor it

«They are different and often add up to each other: it is simplistic to say that they are only due to a bad use of the voice or a bad coordination between breath and voice. Precisely for this reason when the cause must be traced a very detailed picture of the patient is essential including your medical history, occupation and other factors associated with your lifestyle. For example smoke, alcohol abuseconcomitant gastroesophageal (or rather laryngopharyngeal) reflux, chronic intake of certain drugs (for example of inhaled steroids) rather than a low level of ambient humidity are all factors that can contribute to the development of dysphonia».

What does the patient perceive

“Most of the people who come to our structure complain not so much of the qualitative alteration of the voice but rather of the perception of aintense phonatory fatigue. The effort required to speak is such that it involves more than just a sensation of severe irritation in the throatbut also neck and shoulder pains. Overall these subjects feel exhausted and fatigued. The best way to help them is with speech therapy rehabilitation and vocal hygiene measures.

«Another clinical sign, which can accompany the perception of phonatory fatigue, is the presence of a breathy voice, with the sensation of air escaping between the vocal cords. This sign may be consequent to the development of phonotrauma pathologies that is, from traumatic collisions in the vibratory cycle of the vocal cords. The most common benign pathologies from phonotrauma include nodules, oedematous thickenings, often symmetrical, more frequent in women; hemorrhagic polyps, more common in screaming men, which often form following a acute trauma (for example scream at the stadium), which involves the rupture of a capillary with the formation of the polyp; as well as cysts.

The therapies

Once the factors underlying the hoarseness have been established, the specialist will set up the correct therapy, as Cantarella explains. «In pathologies due to phonotrauma and bad use of the voice, speech therapy rehabilitation has a fundamental role because it is a path that teaches the essential rules of vocal hygiene, therefore to learn to use the voice with adequate pauses, volume and tone and to avoid any risk factors such as smoking, alcohol or foods that promote reflux».

«In the event that the hoarseness is linked to laryngopharyngeal reflux, one should be set medical and behavioral therapywith precautions relating to diet and lifestyle, while in the viral forms anti-inflammatory drugs can be used, but it is equally important vocal rest. In the presence of polyps or cysts, surgical treatment is indicated (today less and less invasive), while the nodules usually, at least at the beginning, can benefit from a rehabilitation treatment”.