Symptoms
Hoarseness describes a change in voice quality. The voice may sound smoky, noisy, strained, raspy, trembling, or weak.
Causes
The larynx is made up of cartilage, muscle, and mucosa. It is innervated by the vagus nerve. If any of these elements is disturbed, hoarseness may result. 1. inflammation (laryngitis):
- Viral infections, for example, a cold.
- Pseudocroup in children
- Bacterial infections, for example by chlamydia, staphylococci, streptococci (streptococcal angina), mycoplasma, Moraxella catarrhalis, Haemophilus influenzae (epiglottitis), tubercle bacilli (laryngeal tuberculosis).
- Fungal infections: Candidamycosis
- Inflammation of the vocal cords due to reflux of gastric acid (reflux laryngitis).
- Allergic laryngitis
- Sarcoidosis, arthritis
2. neoplasms:
- Benign or malignant neoplasms, e.g. laryngeal carcinoma.
3. neurological causes:
- Spasms of the musculature
- Weakness or paralysis of the vocal cords due to nerve damage
- Parkinson’s disease, stroke, multiple sclerosis.
- Essential tremor
4. other causes:
- Overuse, for example, after singing or shouting, in abnormal use of the voice.
- Incorrect speech technique, tics
- Accumulation of fluid in the vocal cords (Reinke’s edema), atrophy of the vocal cords.
- Injuries, for example, after intubation, obstruction by foreign bodies.
- Hypothyroidism
- Cysts, polyps
- Medications such as aldosterone antagonists, bisphosphonates, or inhaled glucocorticoids. Anticholinergics such as antihistamines or tricyclic antidepressants dry out the mucous membranes.
- Irritating and corrosive chemicals
Risk groups
- Users of stimulants (smoking, alcohol) and intoxicants, for example cannabis.
- Asthmatics who use inhaled glucocorticoids.
- People who need their voice regularly, such as singers, teachers, lawyers, barkers, sergeants, coaches or active participants in sports events.
- Psychologically stressed and stressed people who use their voice compensatory wrong.
Diagnosis
Diagnosis is made based on patient history and physical examination (laryngoscopy and other visualization techniques). When to see a doctor. Because hoarseness can have serious consequences, clarification should be sought from a physician if it persists for more than 2 weeks, especially if there is no cold or other identifiable cause. A foreign body sensation, pain when speaking and other accompanying symptoms also require a visit to the doctor.
Nonpharmacologic treatment
- Drink fluids or tea regularly, 6-8 glasses per day.
- Avoid medications that dry out the mucous membranes, such as anticholinergics.
- Do not smoke and do not consume alcohol. Coffee has a diuretic effect and can thus dehydrate the body.
- Humidification
- Warmth on the neck, scarf, turtleneck sweater.
- Spare the voice, do not shout or regularly speak loudly
- Do not overuse, speak normally
- Tips against acid complaints in reflux laryngitis.
- Voice training
Drug treatment
Drug therapy depends on the cause. Thus, antifungals are used for candidamycosis, antibiotics for streptococcal angina, or proton pump inhibitors for reflux laryngitis. Inhalations, lozenges, bronchial pastilles, sage pastilles, and candies nourish the mucous membranes and stimulate salivation. Herbal medicines such as chamomile and sage are also anti-inflammatory. Mucilage drugs such as marshmallow, mallow and Iceland moss have an irritation-relieving effect. Local anesthetics have a pain-relieving effect if pharyngitis is present at the same time.
