Hoarseness is so common, why does it never get better?

Some time ago, actress Qin Lan's cute "electronic music" in a variety show made people laugh. But there are reports that her vocal cords were unable to close, causing the symptoms to last for several months and have not recovered.

Hoarseness is actually a common symptom. Why does it persist? Let’s talk about it today.

01

What causes “electric voice”?

The vocal cords are an important structure for human vocalization. When pronouncing a word, the two vocal cords are completely closed and sound is produced through the vibration of the mucosal waves at the edge of the vocal cords.

Anatomy of the larynx

Source: Otorhinolaryngology Head and Neck Surgery Textbook

Any disease that causes changes in the vocal cord mucosa will cause changes in the voice , such as tumors, laryngeal reflux, paralysis of the laryngeal nerves, vocal groove (atrophy), vocal cord deformity, vocal cord allergy, and foreign bodies. For example, when we have a cold, the throat will be infected, especially the vocal cord mucosa will be congested, edematous, and thickened, causing the vibration frequency and amplitude of the vocal cord to become unstable, the vocal ability will further decrease, and the voice will become hoarse. In addition, when working in cold weather and plateau environments, it is more likely to have voice problems because of the congestion of the vocal cords , so you need to pay more attention to the use of your voice.

Image source: Photo Network

In addition, there is another most common reason - overuse of the voice . Generally speaking, using the voice for more than 5 hours a day is considered overuse. Long-term vocalization and speaking too loudly will cause the impact force when the vocal cords close. High-frequency and high-intensity impacts can easily cause tissue lesions at the largest contact point of the vocal cords. And when the voice is hoarse, patients often squeeze their throats to speak in high pitch. Although the larynx is in discomfort, it still has to work at a high intensity. This long-term squeezing will cause an abnormal increase in the tension of the laryngeal and extra-laryngeal muscles, and finally lead to lesions in the laryngeal mucosa, ligaments, and muscles.

Performing arts professions often require long-term use of the voice, so practitioners are more likely to suffer from vocal cord swelling and vocal cord damage. When the acute phase subsides, vocal cord closure problems arise, causing hoarseness.

02

Can the “electronic voice” be improved?

It is generally believed that voice diseases are mostly based on poor pronunciation methods and develop under the influence of inducing factors such as infection, inflammation, and vocal fatigue. They gradually develop from the initial reversible pronunciation disorders to partially reversible or irreversible organic lesions of the pronunciation system.

In fact, when hoarseness occurs in the throat, no matter what the cause is, overuse of the throat at this time will cause high muscle tension, laryngeal congestion and inflammatory environment to greatly interfere with the normal work of the vocal cord system. The vocal cords themselves have been forced to compensate for work damage in the inflammatory environment, causing patients to have persistent difficulty in speaking, and the hoarse voice is not easy to recover.

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Image source: Photo Network

In the early stage of symptoms, if the throat can be rested and voice training is performed, the throat can recover in most cases. For example, hoarseness caused by a cold usually recovers after the illness is cured, but there are exceptions, such as hoarseness caused by recurrent laryngeal nerve paralysis caused by viral infection, which not all patients can recover.
There are many reasons for long-term hoarseness, such as chronic laryngitis, scars after vocal cord injury, vocal cord atrophy (vocal cord groove), vocal cord paralysis, etc. These all require voice rehabilitation training and drug treatment in professional institutions.

03

How to protect your throat?

The importance of our voice to us is self-evident, and vocal health care is the core of voice therapy.

Note:

Pay attention to eating a light diet, drinking plenty of water, getting enough rest, and enhancing immunity.

Be careful not to speak loudly or yell for a long time, and don't speak too fast.

Stay away from tobacco and alcohol. Smoking and drinking have been proven to be the main independent risk factors for laryngeal cancer.

Too high or too low ambient temperature, dry air, high ambient dust concentration, etc. can all reduce the tolerance of the vocal cords, and it is not advisable to overuse the voice at this time.

During menstruation and pregnancy, due to changes in hormone levels, women's vocal cords will have mild edema, the tolerance of the vocal cords will decrease, and excessive use of the voice will cause irreversible voice problems.

For people who speak frequently in daily work and life, we can also take some measures to protect our voices as much as possible.

Specific measures:

Lower your speaking volume: When speaking loudly, the throat and vocal cords are overly tense, which can easily lead to congestion, edema, and sore throat. You can lower your speaking volume to relax the local muscles in the throat and avoid worsening of the discomfort symptoms.

Take a deep breath: When you take a deep breath, more air enters the airway through the throat, which can relax the local muscles of the throat and gradually relax the muscles throughout the body.

Yawning: Similar to the principle of deep breathing, because more gas enters the throat, the local muscles are relaxed instead of needing to remain tense to prepare for vocalization.

Humming or lip blowing exercises: You need to close your lips tightly and make a humming sound in the throat, similar to humming a tune, or you can blow air into your lips with your lips closed, making a burbling sound. Both of these can allow more air to pass through the throat, making it relaxed.

Massage the throat: Massage the throat can promote relaxation of local tense muscles and avoid local congestion and edema caused by long-term tension.

In addition to the above, you can relax your head, lower your throat, avoid excessive tension in the local muscles, or keep your throat moist by drinking warm water or eating throat-soothing foods, which will help with local relaxation. I wish you all a good voice!

Author: Xu Weihua, Director and Chief Physician of Otolaryngology Department, Shanghai Pudong District Central Hospital

Editor: One person