A scratchy throat, pain when swallowing and finally the voice remains away. Everyone knows these symptoms of hoarseness from their own experience, albeit due to different causes. But what exactly happens when our voice fails? What are the causes of hoarseness? And how can we treat hoarseness? We give tips against the discomfort!
How does our voice work?
The larynx is responsible for human voice production. It is located on the front side of the neck at the upper end of the trachea. In men, it can be seen more or less clearly from the outside as the Adam’s apple. Inside the larynx, the two vocal folds are stretched. The free inner edges of the vocal folds are called vocal cords. The vocal folds can be moved by muscles, cartilage and joints so that they close the trachea except for a small gap. This narrowest part of the trachea is called the glottis. When we breathe, the vocal folds are relaxed so that air can flow freely in and out of the lungs. To produce a sound, we tense the vocal folds. The air flowing out of the lungs causes the vocal cords to vibrate. Incidentally, the woodwind instruments bassoon and oboe also function according to a similar principle. The more relaxed the vocal folds are, the slower they vibrate and the deeper the tone. If they are tense, they vibrate faster and the tone is higher. From this basic tone, we now form words and sentences with the help of our throat, mouth and nose; we speak or sing, shout loudly or whisper softly.
What causes hoarseness?
There are many causes of hoarseness – but they all result in our vocal cords not being able to vibrate freely: We are hoarse, the voice is occupied, scratchy or fails completely.
Hoarseness due to infections
Hoarseness often occurs with colds or flu, along with colds, coughs and sore throats, as a sign that the body is flooded with pathogens. The infection leads to swelling of the mucous membrane in the area of the vocal cords, so that the vocal cords are restricted in their mobility.
Hoarseness due to overwork
If the voice is permanently strained by constant loud singing or speaking, for example by singers or teachers, this can also lead to hoarseness because the vocal cords become slack over time. Due to the constant strain, the mucous membrane on the vocal folds swells and small nodules form, the so-called crying or singing nodules. Sometimes these nodules develop into Reinke’s edema, a swelling of the entire vocal folds. Polyps, benign growths of the mucous membrane, can also develop from vocal fold nodules.
Hoarseness and tumor
Another possible cause of hoarseness may be a tumor in the larynx. Benign changes include vocal cord nodules or vocal cord polyps, while malignant changes include laryngeal cancer or labial ligament carcinoma.
Hoarseness after surgery
Surgery in the throat can injure the larynx or the vagus nerve, which is responsible for vocal cord function. Special attention must also be paid to the larynx during intubation, the insertion of a tube into the trachea for ventilation.
Hoarseness due to pseudocroup
Pseudocroup is an inflammation of the larynx caused by viruses. It often occurs in younger children between one and five years of age. There is swelling of the mucous membrane just below the vocal cords, the typical barking, raspy cough and hoarseness.
Other causes of a hoarse voice
Smoking and chemical irritants can also irritate the mucous membrane in the larynx area to the point of hoarseness – as can breathing very cold or very dry air. In addition, allergies, tuberculosis, diphtheria, or Hashimoto’s thyroiditis can produce a hoarse voice.
Hoarseness: duration and symptoms
If the hoarseness lasts longer than two weeks, in addition to severe pain or shortness of breath, you should see an ear, nose and throat doctor. For example, the doctor will ask you about the duration of hoarseness, other symptoms such as pain, fever or difficulty breathing, and previous surgeries, or whether you have had contact with chemical irritants such as ammonia or hydrochloric acid.
Hoarseness: examination and diagnosis
During the physical exam, he or she will look closely at your mouth and throat and palpate the lymph nodes.If an infection is detected, he takes a swab and uses it to prepare a culture. In this way, he can find out which pathogen is the cause of the inflammation. A blood test can also be helpful. To examine the larynx in detail, the doctor performs a laryngoscopy. This may be uncomfortable for you, but it allows him to determine, especially if you then do some speech exercises, whether the vocal folds move laterally or whether they are restricted in their mobility. Further examinations such as ultrasound, X-ray, magnetic resonance imaging or computer tomography may then be performed to rule out a tumor, for example.
Treating hoarseness
If hoarseness is caused by a cold or mild vocal strain, you can do a lot yourself to help the mucous membrane decongest. Otherwise, the doctor will help you.
Hoarseness: what to do? Act yourself!
These tips will help against hoarseness:
- The most important thing is to take care of your voice. Avoid talking and even whispering, because this strains the vocal cords.
- Hot drinks such as herbal teas as well as steam baths, for example, with chamomile relieve the scratchy feeling in the throat.
- Add a handful of sage leaves in half a liter of boiling water and then let the mixture infuse for five minutes. Then pour off the liquid, add a teaspoon of vinegar and a tablespoon of honey and gargle several times a day with this solution. Spit out the solution after gargling.
- Sucking throat lozenges stimulates saliva production and keeps the throat moist.
- Dry indoor air, especially in winter, you can combat with a humidifier or damp cloths.
- Eat chives – it strengthens the vocal cords!
- Both active and passive smoking (smoky pubs!) Are absolutely taboo.
- Put some curd on a damp linen cloth and tie the cloth around your neck. Wrap another linen cloth and then a woolen cloth over it. Leave the curd wrap overnight.
Hoarseness: treatment by a doctor
In case of infection, the doctor may initiate treatment with antibiotics. Vocal fold nodules, Reinke’s edema and polyps of the vocal folds always require surgery. Usually, microsurgery is sufficient or a laser scalpel is used – both methods are gentle and relatively bloodless. In the case of a malignant tumor, extensive treatment with surgery, chemotherapy and/or radiation is necessary. Tea as a home remedy: which tea is good for what?
