A dysphonia is any alteration that occurs in the emission of the voice perceived by the patient and/or his environment. In the non-medical field it is often mistakenly referred to as aphonia or aphonic voice, although from a strict point of view this would represent the total loss of voice.
Causes, symptoms and treatments of dysphonia
The causes can be various, from a common cold to tumor lesions, although fortunately the most frequent cause is an inflammation of the vocal cords due to vocal overexertion (shouting, singing, etc.) or to an infectious process of the upper respiratory tract affecting the larynx (cold, flu, etc.).
We can differentiate between two types of dysphonia: acute and chronic.
– Acute dysphonia
Acute dysphonia is usually self-limited and resolves with voice rest and some symptomatic treatment.
– Chronic dysphonia
This is a more complex issue since its causes can be multiple: from tumor lesions to congenital lesions.
As an important general rule we should take into account that a dysphonia lasting more than 10-15 days, especially in a smoker patient, requires a visit to an ENT specialist for a visual examination of the larynx to rule out the presence of a tumor or cancerous lesion which, if diagnosed in time, has a very high cure rate.
Regarding the rest of chronic dysphonia, we could also make a subclassification in: congenital lesions and acquired lesions.
– Congenital lesions: These are lesions at the level of the vocal cords that are present from birth, although they may show symptoms many years later. Among them we can find: cysts, sulcus, vergetures, etc. These lesions, once diagnosed, have a double treatment: on the one hand with vocal reeducation by a speech therapist specialized in the treatment of voice disorders, and on the other hand with surgery, specifically laryngeal microsurgery. These treatments are not mutually exclusive and are therefore perfectly complementary.
– Acquired lesions: These are lesions produced in general by a bad habit in the use of the voice, either acutely or, in most cases, chronically. Acquired lesions include: nodules, polyps, fusiform edema, Reinke’s edema, papillomas, etc.
We will focus on the most common ones:
– Nodules: Fundamentally they are generated due to a chronic inadequate use of the voice. Typically occurs in children and women who use the voice for many hours a day (teachers, sales clerks, singers, etc.). The treatment consists mainly of vocal reeducation by the speech therapist, and in some cases surgery by the otolaryngologist or phono-surgeon.
– Polyps: They are produced by vocal overexertion, sometimes abruptly. It occurs more typically in men than in women. When it is found in women, an associated congenital lesion must be ruled out. Treatment is basically surgical, but voice re-education is recommended, since without it, the possibility of recurrence after surgery increases.
– Reinke’s edema: This is a benign lesion secondary to smoking. First of all it is necessary to stop smoking. Depending on the stage of the edema and the voice needs of the patient, phonosurgery also plays an essential role.
In summary, if dysphonia lasts more than 10-15 days, it is necessary to consult an ENT specialist for a thorough examination and appropriate treatment.