Laryngitis
Vocal nodules & vocal cord polyps
Contact ulcers

Who Is At Risk?

Anyone who uses his or her voice excessively may develop a vocal abuse or misuse disorder. These problems are fairly common among

Pastors & Ministers
Worship Leaders
Speakers
Telemarketers
Lawyers
Teachers
Cheerleaders
Singers
Actors
Children

Laryngitis*

Laryngitis is inflammation of the voice box (larynx). The most common cause of laryngitis is a viral infection of the upper airways, such as the common cold. Laryngitis also may accompany bronchitis or any other inflammation or infection of the upper airways. Excessive use of the voice, an allergic reaction, and inhalation of irritants such as cigarette smoke can cause short-lived (acute) or persistent (chronic) laryngitis. Bacterial infections of the larynx are extremely rare.

Symptoms are an unnatural change of voice, such as hoarseness, or even loss of voice that develops within hours to a day or so. The throat may tickle or feel raw, and a person may have a constant urge to clear the throat. Symptoms vary with the severity of the inflammation. Fever, a general feeling of illness (malaise), difficulty in swallowing, and a sore throat may occur in severe infections.

A diagnosis is based on the typical symptoms and voice changes. Sometimes a doctor looks down the throat with a mirror or a thin, flexible viewing tube, which shows some reddening and sometimes some swelling of the lining of the larynx. Because cancer of the larynx may cause hoarseness, a person whose symptoms persist more than a few weeks should be evaluated for cancer (see Nose and Throat Cancers: Laryngeal Cancer).

Treatment of viral laryngitis depends on the symptoms. Resting the voice (by not speaking), drinking extra fluids, and inhaling steam relieve symptoms and help healing. Whispering, however, may irritate the larynx even more. Treating bronchitis, if present, may improve the laryngitis. An antibiotic is given only for infection caused by bacteria. *Editors note:Singers Saving Grace utilizes the healing properties of Echanecea.

Vocal Nodules*

Vocal cord nodules and polyps are similar conditions that develop mainly from abuse of the voice (prolonged singing or shouting). Chronic irritation of the larynx, such as occurs with inhalation of cigarette smoke or industrial fumes, or backflow (reflux) of stomach acid at night may also cause a nodule or polyp to form. The growths are similar, but polyps tend to be larger and protrude somewhat more than nodules.

Symptoms include chronic hoarseness and a breathy voice, which tend to develop over days to weeks. A doctor makes the diagnosis by examining the vocal cords with a thin, flexible viewing tube. Sometimes the doctor removes a small piece of tissue for examination under a microscope (biopsy) to make sure the growth is not cancerous.

Treatment is to avoid whatever is irritating the larynx and rest the voice. If abuse of the voice is the cause, voice therapy conducted by a speech therapist may be needed to teach the person how to speak or sing without straining the vocal cords. Most nodules go away with this treatment, but most polyps must be surgically removed to restore the person's normal voice.

Contact ulcers*

Contact ulcers are raw sores on the mucous membrane covering the cartilage to which the vocal cords are attached.

Contact ulcers are usually caused by abusing the voice with forceful speech, particularly as a person starts to speak. These ulcers typically occur in teachers, preachers, sales representatives, lawyers, and other people whose occupation requires them to talk a lot. Smoking, persistent coughing, and backflow (reflux) of stomach acid also may cause contact ulcers.

Symptoms include mild pain while speaking or swallowing and varying degrees of hoarseness. A doctor makes the diagnosis by examining the vocal cords with a thin, flexible viewing tube. Occasionally, a small tissue sample is removed and examined under a microscope (biopsy) to make sure that the ulcers are not cancerous.

Treatment involves resting the voice by talking as little as possible for at least 6 weeks so that the ulcers can heal. To avoid recurrences, people who develop contact ulcers need voice therapy to learn how to use the voice properly. A speech therapist can provide such instruction. If the person has acid reflux, treatment includes taking antacids, not eating within 2 hours of retiring for the night, and keeping the head elevated while sleeping. *Editors note: Slippery elm is a natural antacid.

*Information from the Merck Manual of Medical Information—Second Home Edition