Ear, nose and throat

Consultants

Organic dysphonia

In all organic dysphonias we are able to find an injury to the vocal folds, or near them. Depending on the type of injury, treatment may be medical, surgical or involve rehabilitation:

 

Laryngitis

Inflammation of the larynx is usually associated with infectious causes, usually of a viral nature. Symptoms develop within 12-24 hours. Most cases are resolved with medical treatment.

 

Nodules

This is the most frequent type of organic dysphonia in both children and adults. It is caused by misuse or abuse of the vocal folds. Treatment depends on whether the condition is acute or chronic, but voice therapy usually resolves the disorder in the vast majority of cases. For those who do not improve, surgery may be required.

 

Polyps

This very frequent vocal disorder is characterised by a single injury on the vocal folds. Vocal abuse is the primary cause of polyps, and most of the time surgery is required.

 

Reinke’s edema

This is the generalised inflammation of the vocal folds, and it is closely related to tobacco use. The condition is very noticeable in women because it causes a very low-pitched voice. The primary treatment is to quit smoking, though in some cases surgery is required.

 

Papillomas

Papillomas are caused by the human papilloma virus, and they tend to cause hoarseness. They are benign, but in 5 to 15% of cases they can become malignant, so it is recommended that an ENT test and monitor them.

 

Granulomas

These secondary lesions can be caused by extended intubation, laryngotracheal surgery, and gastroesophageal reflux. Depending on their size, they go unnoticed or cause great irritation when breathing or speaking.

 

Vocal cysts

These can be congenital or be caused by vocal strain. They are small sacs filled with mucus, and they are found in the interior of the vocal fold, causing certain dysphonias.

 

Sulcus

This is a congenital disorder that seems to derive from vocal cysts, but they are empty so it is as if there were ‘pocket’ on the vocal cord. It causes severe hoarseness starting in childhood, and it is one of the most difficult disorders to treat.

 

Vocal fold haemorrhages

As in any other part of our body, one or more of the small blood vessels in the vocal folds may rupture and bleed. It often results from an acute and momentary strain, such as shouting. They are also commonly observed in patients taking antiplatelet medication.

 

Vocal fold paralysis

This disorder occurs when one or both vocal folds do not move, often the result of neck surgery, trauma or colds. They result in a breathy voice that is very ineffective and weak. There is a range of therapeutic options for treating this condition.

 

Leukoplakia

This condition consists of whitish lesions on the vocal folds or in any other mucus membrane in the oral cavity. Their occurrence may signal a malignant or pre-malignant disease. It is closely related to risk factors such as tobacco or alcohol use. When leukoplakic lesions are detected, a biopsy of the lesion is recommended. If the patient has risk factors and their dysphonia lasts for more than one week, they should consult with an ENT to rule out malignancy.