Also, sometimes the hoarseness and raspiness can be temporary and responsive to the vocal hygiene strategies discussed below. Patients with hoarseness lasting more than two weeks, pain occurring with speech or swallowing, or a foreign-body sensation in the throat should be examined. 1998 Jun 1;57(11):2775-2782. Commonly referred to as “nodes.”. As with anything body-related, the first question is ask yourself is: how long has this vocal hoarseness or raspiness been going on? It also suggests some of the things you can do to help keep your voice healthy and avoid hoarseness (a change in voice quality) and discomfort. Microsurgical removal of the nodules is rarely necessary, but may be considered after failure of maximal attempts at voice therapy. 1991;101(4 Pt 2 Suppl 53):1–78. Voice requires four components: 1. the lungs to provide a sufficient air stream through the vocal cords 2. the larynx and, specifically, the vocal cords to create the sound 3. the resonance chamber made up of the pharynx, nasal and oral cavities, which project the sound 4. the nervous system, which provides overall control. Woodson GE. Am J Otolaryngol. A voice disorder resulting from excessive or unequal tension while speaking. A patient to consider in a special way is the professional voice user—anyone, from teachers to professional singers, whose occupation or livelihood depends on the normal use of the voice. These persons need earlier and more aggressive intervention and often require more specialized care. How Speech and Language Therapy Can Help With Hoarseness 10 September 2012. A loss of the ability to sing high notes or to change pitch easily, or loss of sensation in the larynx and pharynx, therefore, may be caused by a lesion affecting the superior laryngeal nerve. a singer or teacher), managing the strain on your voice is often best done with an experience speech pathologist. An important consideration, therefore, is the innervation of these muscles and the characteristic features of lesions of these nerves. Dickson DR, Maue-Dickson W, eds. Length of therapy is determined by diagnosis, the condition of the vocal folds, vocal habits, motivation and compliance with the therapeutic program. He denied symptoms of airway compromise, dysphagia or throat pain. The generalized increase in muscular tension has several interacting causes, including poor vocal technique, extraordinary voice-use demands and psychologic factors such as anxiety.8 Vocal fatigue and discomfort are common presenting symptoms in patients with muscle tension dysphonia. A more recent article on hoarseness in adults is available. Other aspects of the history include the nature and timing of the dysphonia; associated symptoms such as pain, dysphagia, cough or shortness of breath; symptoms of gastroesophageal reflux, such as an acid taste in the mouth in the morning; associated sinonasal diseases (allergic rhinitis or chronic sinusitis) and use of medications that dry the upper airway mucosa. Most voice disorders are treated with some form of voice therapy by a licensed speech pathologist that focuses on care for voice problems. If it came on suddenly two days ago, that’s probably not enough time to consider it an issue at all. Am J Otolaryngol. Voice Therapy for Hoarseness in Children Voice therapy is usually the first treatment doctors recommend for children whose chronic hoarseness is caused by a vocal cord lesion—a bump beneath or on the surface of the vocal cords. Other aspects of dysphonia to inquire about, particularly in patients who are singers, are changes in pitch and abnormal pitch range. Vocal cord paralysis, abductor spasmodic dysphonia, functional dysphonia, Vocal cord lesion, muscle tension dysphonia, reflux laryngitis, Reinke's edema, vocal abuse, reflux laryngitis, vocal cord paralysis, muscle tension dysphonia, Adductor spasmodic dysphonia, muscle tension dysphonia, reflux Laryngitis, Parkinson's disease, essential tremor of the head and neck, spasmodic dysphonia, muscle tension dysphonia, Muscle tension dysphonia, vocal cord paralysis, reflux laryngitis, vocal abuse. Later presentations may include throat irritation, hemoptysis, dysphagia or referred otalgia. With the exception of the cricothyroid, all of the intrinsic muscles of the larynx are innervated by the recurrent laryngeal nerve. 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