Symptoms
Voice disorders with this pathology are manifested in hoarseness or hoarseness of timbre, decreased voice strength, decreased tonal range, vocal fatigue, and unpleasant sensations in the larynx. Breathing becomes shallow, phonation exhalation is reduced. The degree of voice impairment varies from mild to severe, making it difficult to perceive speech. All this can lead to the impossibility of fulfilling one’s professional duties and complicates communication at home. Symptoms of voice changes should not be ignored. It is necessary to contact a phoniatrist in a timely manner.
How does the human vocal apparatus work?
The larynx is not only part of the respiratory tract, it is an organ of sound production. It contains the vocal cords, a paired organ that is a collection of muscles. When a person is silent, there is a distance between the ligaments - the laryngeal cleft. For sound to be produced, the ligaments must be pressed tightly against each other. With such a tight closure, the air flow leaving the lungs as you exhale passes through the closed ligaments, causing them to vibrate. At this moment, sound arises and we hear human speech.
If the voice becomes hoarse and hoarse, it means that the ligaments cannot fit tightly together, as a result of which the sonority of speech is lost.
A condition in which the vocal cords become hoarse can be caused by their inflammation or a number of other reasons, which we will discuss further.
Examinations and treatment
In the Phoniatrics of the Federal State Budgetary Institution NKCO FMBA of Russia, high-tech endoscopic research methods are widely used, such as:
— videolaryngostroboscopy – a method that allows you to assess the macromorphological function of the larynx (XION medical);
- high-speed video laryngostroboscopy - a method with high image clarity makes it possible to obtain up to 4,000 color images per second and dynamically record 20 images during one period of oscillation of the vocal folds (Richard Wolf apparatus);
— video fibronasopharyngolaryngoscopy – a method that allows diagnosing cancer in situ, epithelial dysplasia of varying degrees, as well as diagnosing precancerous diseases of the larynx by obtaining a full-fledged high-definition image;
— NBI — narrow-spectrum endoscopy is one of the most modern technologies introduced into practice, which allows a specialist to visualize all changes in the vascular structure of the mucous membrane, typical for neoplasms (Olympus OEV261H, CV-170).
Using these modern methods, a specialist will be able to make an accurate diagnosis of the patient and prescribe appropriate treatment. After this, it is necessary to begin rehabilitation of vocal function as soon as possible.
Voice restoration is possible using a non-surgical method - phonopedia.
Exercises to strengthen the throat and relieve tension.
1. “Horse”. Click your tongue loudly and quickly for 10-30 seconds.
2. “Crow”. Say “Ka - aa - aa - ar.” Look in the mirror while doing this. Try to raise the soft palate and small tongue as high as possible. Repeat 6-8 times. Try to do this silently.
3. “Ring”. Sliding the tip of your tongue tensely across the palate, try to reach the small tongue. Do this with your mouth closed several times.
4. “Lion”. Reach your tongue to your chin. Repeat several times.
5. “Yawning.” Yawning can be easily induced artificially. So call him several times in a row as gymnastics for the throat. Yawn with your mouth closed, as if hiding the yawn from others.
6. “Tube”. Draw out your lips with a tube. Rotate them clockwise and counterclockwise. Reach your lips to your nose, then to your chin. Repeat 6-8 times.
7. “Laughter.” While laughing, place your palm on your throat, feel how tense the muscles are. Similar tension is felt when performing all previous exercises. Laughter can also be induced artificially. From the point of view of muscle function, it doesn’t matter whether you laugh or just say “ha ha ha”. Artificial laughter will quickly awaken high spirits and lead to natural fun.
The normal state of the vocal apparatus is when all mucous membranes are moisturized
.
A runny nose, dry mucous membranes, inflammation of the nasopharynx often knock us out of working condition, greatly influence and change the internal sensations that the singer uses, and disorient these sensations.
In such conditions it is impossible to work with the voice. You must be able to cope with ailments, take effective measures at the first symptoms of the disease in order to quickly return to working condition. It’s even better to learn how to prevent diseases using all kinds of preventive measures.
The next chapter will be a small “medical reference book” of first aid.
Of course, treatment must be done under the supervision of a doctor.
, but there are often situations where a person must be able to competently take some measures before consulting a doctor.
Very often we hear the phrase: “Catarrhal state.” What is catarrh?
Catarrh is an inflammation of the mucous membranes, accompanied by their redness, swelling, formation and secretion of fluid (transparent, mucous, purulent).
Katarr - from the Greek katarreo - flowing down.
Catarrh can be a cold or infectious.
Cathars are:
1. upper respiratory tract (rhinitis, pharyngitis, laryngitis, tonsillitis, tracheitis);
2. bronchi (bronchitis).
The most common disease of the nasal mucosa is rhinitis (in popular usage - runny nose).
The best remedy for preventing acute colds is hardening the entire body. The cause of a runny nose is a cold, cold. This reduces the body's resistance to fighting infection.
Sometimes, with an acute runny nose, the process can spread to the mucous membranes of the paranasal sinuses, which is called sinusitis
.
An example of sinusitis is the often occurring inflammation of the maxillary sinus - sinusitis
, and inflammation of the frontal sinus -
frontal sinusitis
.
A frequently recurring runny nose can become chronic. This happens when the body's resistance to infection is weakened due to recent other illnesses (for example, influenza); when a person is in conditions of a sharp change in temperature and inhales either cold or hot air; when inhaling dusty air, contaminated with smoke, gas.
Atrophic _
runny nose, which causes unpleasant sensations of dryness and accumulation of crusts in the nose and nasopharynx, and sometimes dulling of the sense of smell and its complete loss.
This is due to a malnutrition of the nasal tissues due to improper function of the autonomic nervous system. The same reason causes hypertrophic
runny nose, in which the nasal turbinates grow and the nose becomes stuffy.
Treatment of a runny nose should be carried out by a doctor, since a runny nose can be the first manifestation of other common diseases (measles, flu and others).
First aid:
For inflammation of the nasal mucosa, a menthol pencil is very helpful. Distraction procedures that are good for nasal congestion are:
1. hot foot baths;
2. mustard plasters on calves, on feet;
3. 1-2% ephedrine solution, 5 drops in each nostril, after 2-3 hours;
4. 1% menthol oil, 5 drops, 3 times a day;
5. inhaling streptocide powder through the nose.
Rule for instilling drops into the nose:
drop the medicine into the nostril and tilt your head to your shoulder in the same direction.
Rules for cleaning your nose when you have a runny nose:
with an acute runny nose, especially when the nose is completely stuffy,
you should not blow your nose.
At this time, there are many pathogenic microbes in the nose or nasopharynx. When blowing your nose, mucus can enter the middle ear from the nasopharynx (through the Eustachian tube), and thus cause otitis media. If the nose is not completely blocked, the mucus is blown out lightly, without pressure, alternating emptying the left and right nostrils.
If a healthy person needs to blow his nose, he must keep his mouth half open and carefully release first one and then the other nostril.
Inflammation of the pharyngeal mucosa - pharyngitis.
With this disease, unpleasant sensations occur: scratching, burning in the throat, dry cough.
Almost always this inflammation affects the larynx to one degree or another.
The occurrence of pharyngitis is promoted by any frequently repeated irritation of the pharyngeal mucosa. Irritants: smoking, alcoholic drinks, too hot and spicy food, too cold food and drinks, temperature fluctuations, dust.
First aid:
1. Systematic gargling with alkaline solutions (1 teaspoon of baking soda and 1 teaspoon of glycerin per glass of boiled water).
2. Alkaline-oil inhalations, but not hot, but warm (hot ones are only harmful for pharyngitis).
3. When coughing, you can take Libexin, Glauvent or other antitussives orally.
Sore throat is inflammation of the tonsils.
The disease occurs in damp, cold weather, and, as an infectious disease, is easily transmitted through communication from sick to healthy. During a sore throat, a person experiences malaise, headache, fatigue, and fever. It is imperative to seek treatment from a doctor, since complications with this disease are common (inflammation of the middle ear, rheumatism, damage to the inner lining of the heart - endocarditis).
First aid:
1. Bed rest until the temperature drops.
2. Warm, liquid food, so as not to injure the sore throat, drink plenty of fluids (warm tea with lemon, Borjomi).
3. Warm compresses on the neck.
4. Gargle with disinfectant solutions:
boric acid (1 teaspoon per glass of water),
rivanol (0.1% solution),
gramicidin (1 ampoule per 1 glass of boiled water),
table salt and iodine (1 teaspoon of soda + 2-3 drops of iodine per 1 glass of water),
infusion of eucalyptus or chamomile (warm),
hot St. John's wort (brew 1 tablespoon per 1 glass of boiling water, leave to infuse. Drink when the temperature becomes acceptable for the mucous membrane). Rinse with warm infusion.
5. Monitor your intestines to avoid constipation (beets, prunes).
6. If you have a high temperature before visiting a doctor:
streptocide 0.5 g 4 times a day,
antibiotics (oletethrin, tetracycline, tetramycin, biseptol).
Good advice:
You should gargle without any tension, trying at these moments to pronounce melodious vowels (A, O, E, I, U).
The shape of the mouth and pharynx changes for different vowels. This helps to wash places in the folds of the mucous membrane that are inaccessible with one vowel.
There is an opinion that if you take a lightly disinfectant liquid into your mouth (a mixture of alkaline salts, a weak solution of rivanol or boric acid) and leave it for a short time in a completely calm state with your head thrown back significantly, then this works much better than actively rinsing.
I will give a few more recipes for the treatment of sore throat. Rinsing:
· In equal proportions (1:1:1), take chamomile, eucalyptus and calendula in an amount of 1 tablespoon of the mixture and boil for 2 minutes in 1.5 glasses of water. Then leave for 30 minutes in a warm place and strain. Gargle 2 times a day (morning and evening), dividing the infusion in half. Start at 20 degrees Celsius, gradually decrease 1 degree, bringing it to 16 degrees. Then rinse for a month with infusion of 16 degrees Celsius.
· Chew small pieces of calamus root 5-6 times a day every day. Keep a piece in your mouth for 15-20 minutes. After six months to a year of such treatment, sore throats disappear forever.
· For a sore throat (at the beginning), chew a piece of lemon with zest. After this, do not eat anything for an hour so as not to wash off the essential oils and acid. Repeat after 3 hours.
Chronic tonsillitis
- chronic inflammation of the palatine tonsils, developing as a result of frequent sore throats.
The course of the disease during exacerbation of chronic inflammation is accompanied by high fever, abscesses in the throat, changes in general condition: headache, lethargy, decreased ability to work.
Treatment is carried out only by doctors.
Outside of an exacerbation, the following have a positive effect: lubricating the tonsils (with Lugol), removing plugs, rinsing, and physiotherapy.
If conservative treatment methods are unsuccessful, surgical intervention is resorted to, which does not affect voice quality.
Laryngitis
- inflammation of the mucous membrane of the larynx and the vocal cords themselves. The disease can be caused by hypothermia, infection, as well as overstrain of the vocal cords and excessive stress.
The inflammatory process can spread to the mucous membrane of the nose and pharynx, often vice versa.
Symptoms: sore throat, sore throat, hoarseness, loss of voice, cough (first dry, then with phlegm), malaise, headache, sometimes fever.
Long-term illness, long-term loss of voice.
Treatment is always under the supervision of a doctor.
First aid:
1. Elimination of external causes that caused laryngitis (cold food, drinking, damp, cold, dusty air, smoking, alcohol).
2. Reduction or complete elimination of vocal load - silence.
3. Alkaline warm inhalations several times a day (warm, not hot).
4. Mustard plasters on the neck, back, legs.
5. Warm compresses on the neck.
6. Rinsing, lubricating, hot mulled wine.
7. In case of elevated temperature - bed rest, call a doctor.
Tracheitis
- inflammation of the tracheal mucosa.
This disease is very common among people in “vocal” professions, since excessive vocal stress leads to irritation of the mucous membrane of the trachea, which makes it more susceptible to infection, colds, sensitive to temperature fluctuations, and drafts.
With tracheitis, the mucous membrane swells and vocal function is impaired while the vocal cords remain unchanged.
There is a cough with sputum, sometimes very viscous and difficult to cough up, fatigue, hoarseness, inaccuracy of intonation, dryness, scratches, burning in the throat when trying to sing.
It matters which part of the trachea is inflamed. Vocal function is especially affected by subglottic tracheitis.
First aid
the same as for laryngitis.
In prolonged cases, the doctor prescribes quartz, sollus, UHF, electrophoresis (with potassium iodide on the larynx), and expectorant mixtures.
Some doctors argue that in addition to infectious tracheitis, tracheitis may occur due to a sharp increase in intrabronchial pressure when forcing the voice, screaming, overstrain of breathing, or improper singing.
Bronchitis
- inflammation of the bronchial mucosa. The disease is often accompanied by inflammation of the mucous membrane of the upper respiratory tract (nose, pharynx, larynx, trachea).
Bronchitis can be caused by infection, colds, or unfavorable environmental conditions (gas pollution, dust).
The occurrence of bronchitis can also be facilitated by weakening of the body due to previous diseases, unfavorable working conditions, living conditions and bad habits (alcoholism, smoking).
Bronchitis is often preceded by a runny nose, hoarseness, tickling in the throat, then a cough, at first dry, rough with scanty sputum. Soon there is a feeling of rawness behind the sternum, aggravated by coughing.
After a few days, expectoration becomes easier, the sputum is profuse, mucopurulent.
First aid
, as with laryngitis and tracheitis. Treatment is required under the supervision of a doctor to prevent it from becoming chronic and causing complications with the lungs.
Flu.
This disease most often affects the upper respiratory tract and primarily disables “voice workers.”
We must be able to take precautions, especially during epidemics.
1. Of course, avoid contact with sick people if possible. Do not use public catering facilities.
2. It is useful to rinse the mouth and pharynx at least 3-4 times a day with a solution of potassium permanganate (a small grain per 1 glass of boiled water) or a solution of rivanol (1:4000), or a solution of boric acid and table salt (1/2 teaspoon each per 1 glass of boiled water).
3. Special medications and vaccines against influenza help prevent the disease. A good anti-influenza serum is in powder form, which is inhaled through the nose.
Advice:
Handkerchiefs of a person with the flu must first be boiled and then washed. It is better to use napkins and then throw them away. This reduces the possibility of transmitting infection.
Gauze bandages or no contact with the patient are very effective.
Phonopedia
Classes are conducted by a speech therapist who has completed specialization in phoniatrics and phonopedia - phonopedist . Phonopedic training includes breathing, voice and relaxation exercises. Their goal is to activate the internal muscles of the larynx, form costo-abdominal breathing, coordinate phonation and breathing, and relieve excessive tension. These workouts have no contraindications or side effects. Voice restoration is based on the body's compensatory capabilities. The duration of the course is from 2 to 4 months.
Along with traditional phonopedic classes, remote ones , which makes it possible to provide specialized speech therapy assistance to such patients in all regions and corners of the Russian Federation. Our experience in managing patients with paresis and paralysis of the larynx shows that all patients after rehabilitation training had a positive result, which consisted of an improvement in the laryngoscopic picture, an increase in the tonal and dynamic range, time of maximum phonation, voice endurance, improvement in timbre characteristics, and sound stability. In 48% of patients, not only the quality of the voice improved, but also the mobility of the vocal fold was restored.
Corrective and pedagogical methods of voice restoration are highly effective and have no contraindications methods for the rehabilitation of patients with paresis and paralysis of the larynx.
