Definition
The designation of swollen vocal cords is very misleading and from an anatomical point of view is to be regarded as wrong. Because it is not the vocal cords that swell, but the vocal folds. The vocal cords themselves consist only of taut connective tissue, which impresses as elastic fibers.
They are the continuation of our vocal muscle and are attached to the cartilage skeleton of the larynx. They are covered by an epithelium, but do not contain any blood vessels themselves. This is why they are paler in appearance than the surrounding structures. In so-called “swollen vocal cords”, the vocal muscle or the space between the epithelium of the vocal folds and the vocal muscle swells, as these structures have good blood circulation. This phenomenon is known in medical terminology as Reinke’s edema.
Causes
The causes of “swollen vocal chords” are usually viral infections in the context of a common cold or bronchitis. The viral pathogen of whooping cough is mainly found in children as a trigger for a swollen vocal fold. But it does not always have to be infections that affect the function of the vocal chords.
Incorrect strain on the vocal chords through speaking, singing or screaming can also lead to irritation of the vocal fold. Especially teachers or singers are often affected professional groups. The consequence of the irritation is with all causes that the vocal folds are inflamed and it comes reactively to a better blood circulation with an increased liquid accumulation.
The accumulation of fluid in turn causes the opening between the vocal folds to become smaller and thus impairs their ability to vibrate. The resulting symptoms are an altered voice and optionally difficult breathing. An allergy can also cause “swollen vocal cords”.
Every allergy triggers an excessive defensive reaction of the immune system, which manifests itself in an inflammation. In principle, the inflammation is possible everywhere. Typical for “swollen vocal chords” would be an insect bite.
By swallowing insects in summer from a lemonade glass, the sting of a bee or wasp can massively irritate the mucous membrane in the area of the larynx and lead to rapid swelling due to a reactive inflammation. This is often manifested by rapidly increasing shortness of breath, which requires immediate treatment. Other allergies, such as animal hair allergy or hay fever, can also lead to swollen vocal folds, but are usually milder in their symptoms.
Stomach acid gets into the area of the larynx through the belching of acid stomach contents. The backflow of the gastric juices is called heartburn. If the heartburn is very pronounced, it can theoretically also lead to “swollen vocal chords”, as the stomach acid can attack the tissue layer above the vocal chords.
However, this must involve a massive belching of stomach contents, since the body has the laryngeal flap over the vocal folds as its own protection, which is lowered to seal the airways when swallowing or belching. As a result, the respiratory tract is completely sealed during the swallowing process, and any residue in the throat area is washed away by the swallowing process. Acidic stomach contents can therefore only reach the vocal folds during inhalation if the epiglottis is open or if it is enormously damaged.