Hoarseness is a nonspecific symptom of many laryngeal diseases, ranging from benign polyps to life-threatening cancerous tumors.
The symptoms of hoarseness are easily noticeable, but many people overlook them until the disease becomes severe and causes dangerous complications, only then seeking medical attention.
This article will discuss a new technique for screening the causes of hoarseness and the most effective treatment for cases of vocal cord nodules, vocal cord polyps, vocal cord cysts, papilloma virus, and HPV via flexible endoscopy.
Structure of the vocal organs:
The human vocal organs have a very complex structure. The larynx plays a crucial role in speech formation. Speech is produced when air from the lungs rises; the vibration of the vocal cords acts on this column of air, creating sound. During speech, the vocal cords close tightly, and their shape can change, sometimes thick, sometimes thin, sometimes slightly tense, sometimes very tense, depending on the need for pronunciation.
Voice disorders occur due to temporary or long-term changes in speech function. The main symptom is hoarseness or loss of voice due to uneven vibration of the vocal cords, or the two vocal cords not closing completely during speech.
CAUSES AND TREATMENT OF HOARSENESS:
There are many causes of hoarseness, but they can generally be divided into two groups as follows:
CAUSES DUE TO VOCAL CORD DAMAGE
Chronic inflammation, nodules, cysts, polyps of the vocal cords:
These are commonly seen in people whose jobs require them to speak a lot or loudly, such as teachers, broadcasters, salespeople, and actors. The most common symptom is hoarseness or loss of voice.
Hoarseness significantly impacts professional activities, with some people even having to quit their jobs or leave their profession. The rate of hoarseness due to this cause is quite high. The condition is related to many risk factors such as long working hours, loud voice intensity, smoking habits, alcohol consumption, or certain co-existing conditions such as sinusitis (mainly posterior sinusitis), tonsillitis, gastritis, etc. People working in environments with high noise, dust, and toxic substances, especially coal dust and chemical dust, are also prone to developing the condition.
Endoscopy: reveals local lesions such as chronic inflammation (causing vocal cords to thicken and stiffen, reducing vibration), vocal cord nodules, vocal cord polyps, and vocal cord cysts.
Vocal cord cancer:
Often occurs in people around 40 years old, those who smoke heavily and for a long time, with progressively worsening hoarseness, occasional dry cough, and later coughing up blood; the voice becomes stiff, and weight loss occurs.
Endoscopy reveals tumors and mucosal growths of the vocal cords. In late stages, cancer may invade the pyriform sinus and esophagus, causing painful and difficult swallowing. Tumors can compress the trachea, causing shortness of breath. If detected early, surgical removal of the tumor and radiotherapy are recommended, and the disease is almost always curable.
Laryngeal Tuberculosis: 1
Commonly occurs after pulmonary tuberculosis (55%) or lymph node tuberculosis, in patients aged 20-40. Laryngeal tuberculosis is divided into three stages:
Hoarseness, double voice, gradual loss of voice, dry cough.
Endoscopy: shows pale larynx, red arytenosis.
Deep, low, shaky voice, shortness of breath, raspy voice.
Endoscopy: may show tuberculous lesions and nodules on the vocal cords.
Patients lose their voice, experience severe pain when swallowing, and are unable to eat or drink. Late stages can lead to scarring and narrowing of the trachea, causing shortness of breath.
Endoscopy: may reveal vegetative lesions, ulcers, white pseudomembranes, a "dirty" surface, and tuberculous nodules on the vocal cords, often accompanied by pulmonary tuberculosis. Patients will undergo a biopsy for tuberculosis pathology and will receive antituberculosis treatment.
NEUROLOGICAL CAUSES
Recurrent laryngeal nerve damage causing vocal cord paralysis:
Due to inflammation, post-thyroidectomy, post-laryngeal trauma, chest surgery, mediastinal tumors, lung tumors metastasizing to the mediastinum causing invasion and compression: Hoarseness, weak voice, difficulty speaking, then inability to speak, no difficulty swallowing. Other conditions can also cause hoarseness, such as esophageal tumors, lymph nodes around the trachea and bronchi, aortic aneurysm, and thyroid tumors. The disease usually develops insidiously or rapidly, but when hoarseness occurs, it is usually in the late stages, the disease progresses very severely, and the prognosis is poor.
Endoscopy: shows one vocal cord immobile. With prolonged paralysis, the vocal cord atrophies, and the arytenoid cartilage deviates to the side.
Brain damage causing vocal cord paralysis:
Due to brain tumors, stroke, head trauma, encephalitis, damage to the Broca's area. Often results in slurred speech and loss of voice, accompanied by pharyngeal and palatal paralysis, along with neurological symptoms such as hemiplegia, sometimes coma.
