definition

The vocal cords, the colloquial term for vocal folds, are elastic bands that form part of the larynx (entrance to the trachea). They consist of the glottis, the actual vocal cord ( ligamentum vocale ) and a muscle ( musculus vocalis ). They are important in the formation of voice: Through the incoming air they get into vibration, it creates sounds and a language formation is possible. The inflammation of the vocal cords can be divided into an acute and a chronic form. The inflammation is considered chronic once it lasts longer than 3 weeks. The inflammation of the vocal cords is also called laryngitis .

symptoms

There is pain in the larynx and scratching of the throat with throat irritation and difficulty swallowing. In addition, a hoarseness with a rough voice to the speechlessness ( Aphonie ). Occasionally, fever can occur. In the chronic form, the symptoms persist for at least 3 weeks to months. If reflux is the cause, it comes to irritating cough, which occurs especially at night and heartburn.

The pseudo-croup shows a similar symptomatology, with a barking cough and shortness of breath due to narrowed airways leading to choking anxiety.

difficulty in breathing

A vocal cord inflammation can spread to the entire larynx. The symptoms worsen and the strong swelling of the laryngeal mucosa can cause respiratory problems in very rare cases. The larynx forms the entrance to the trachea, which is why a swelling in this area can shut off the air supply and lead to respiratory distress. This is a potentially life-threatening complication that must be treated promptly by a physician.

causes

In the acute form is usually a descending infection of the upper respiratory tract (nose or throat), which spreads to the vocal cords. In most cases, viruses are the cause, but also an infection by bacteria is possible. The most common pathogens are cold viruses ( rhino or adenoviruses ), influenza viruses ( Haemophilus influenzae ) or pneumococci ( Streptococcus pneumoniae ). Furthermore, a strong vocal load can lead to irritation of the vocal cords.

If acute vocal cord inflammation is poorly treated, chronic vocal cord inflammation may result. Furthermore, smoking, a dusty environment, the wrong vocal technique or the overload of the voice (eg in singers or teachers) as well as a chronic inflammation of the neighboring organs can lead to a chronic inflammation.

The backflow of gastric juice into the esophagus (reflux) may be the cause of a special form of laryngitis.

One form of laryngitis that occurs mainly in infants is the pseudo-group ( laryngitis subglottica ). It is an inflammation that can lead to a strong swelling of the vocal cords. The cause is a viral infection with additional bacterial infection.

So contagious is a vocal cord inflammation

A vocal cord inflammation arises either through mechanical irritation when the voice is overstressed by long or loud talking, or by an infection. Overuse vocal cord inflammation is not contagious, whereas infection is usually caused by bacteria or viruses and can easily be transmitted to other people.

Often it comes in the context of flu or other diseases of the upper respiratory tract, such as pneumonia or whooping cough, also to an infection of the vocal cords. Coughing or sneezing is a common concomitant symptom of these diseases. In the process, the pathogens with the ejected secretion get into the air and can be transmitted to other people by means of droplet infection and cause vocal cord inflammation. Diseased people should be aware of the risk of infection for their fellow human beings and comply with strict hygiene rules. This includes thorough hand washing, keeping distance to other people and only coughing or sneezing in handkerchiefs. Handshakes should also be avoided during the duration of the illness.

therapy

First, the patient should spare his voice and talk only quietly. However, it should not be whispered, as this puts additional strain on the vocal cords and does not protect you as expected. In addition, a waiver of smoking, alcohol and hot spices is indicated. Also warm drinks and steam inhalations can be recommended against the dry feeling and the pain. Slime remedies can help against the mucus.

If it is a bacterial infection, an antibiotic should also be prescribed. If inflammation of the paranasal sinuses or the respiratory tract is present in addition to the inflammation of the vocal cords, these should also be treated.

If the inflammation is based on a wrong vocal technique, treatment by a speech therapist may be useful. This helps to improve the vocal technique and thus to avoid a renewed irritation of the vocal cords.

If the cause of the inflammation is a dusty environment, for example at work, the exposure should be reduced, for example via respiratory masks, as well as possible.

If reflux is present, take medicines that inhibit acid production in the stomach.

The pseudo-group should always be treated in hospital in order to monitor respiratory distress. A dose of antibiotics against the bacterial infection is needed. In case of imminent suffocation, the introduction of a breathing tube into the trachea ( intubation ) or a tracheostomy ( tracheotomy ) may be necessary to ensure ventilation.

When do I need antibiotics?

A vocal cord inflammation can be caused by an infection, whereby usually viruses or bacteria are the triggers for the illness. Viral infections can only be treated symptomatically, whereas bacterial infections require antibiotics. If vocal cord inflammation lasts more than three weeks or if there is no improvement in the symptoms after two weeks, a doctor must be consulted. The doctor examines the vocal cords, takes a smear and can thus determine whether the inflammation has been caused bacterially and antibiotics are required.

These antibiotics are the best way to help

The antibiotic used to treat vocal cord inflammation depends on the type of triggering bacterium. A common pathogen is the bacterium Streptococcus pneumoniae, which is treated with beta-lactam antibiotics, such as penicillin G, or cephalosporins, such as cefaclor, cefuroxime or cefatriaxone. Sprays containing the antibiotic fusafungin act locally on the inflamed vocal cords and can be used in vocal cord inflammation. In the case of drug therapy with antibiotics, it is important for a doctor to prescribe the appropriate remedy and for the patient to adhere precisely to the type and duration of the intake, as otherwise severe side effects or resistance may develop.

When do I need cortisone?

In case of severe infections and if the patient does not respond to antibiotic therapy, it may be necessary to take cortisone-containing preparations. Cortisone is an extremely powerful endogenous hormone that has a strong anti-inflammatory effect. Due to numerous side effects but it may only be used carefully and exclusively on medical recommendation.

Inhale

Inhaling is a great way to speed up the healing of vocal cord inflammation. Herbal tea from medicinal herbs such as Icelandic moss, chamomile or marshmallow root is particularly suitable for this. The hot tea is placed in a bowl and inhaled under a towel for about 15 minutes. Also, a saline solution can be used to inhale. To do this, add a tablespoon of salt to a bowl of hot water and dissolve with stirring. Inhaling the hot vapors moistens the dry vocal cords and has a soothing effect.

homeopathy

A vocal cord inflammation and the resulting hoarseness can be treated homeopathically. The choice of homeopathic medicines is based on the cause of the inflammation and the accompanying symptoms. Globules containing the active ingredients Allium cepa (kitchen onion), Argentum nitricum (silver nitrate), Phosphorus and Ammonium bromate (ammonium bromide) are used. Doctors and pharmacists help to decide which globules are best for the individual patient.

These home remedies can help

There are some old and proven home remedies that help to cure vocal cord inflammation. A simple tip is to drink enough fluid, preferably in the form of warm herbal teas. Especially freshly brewed teas from chamomile, Icelandic moss or marshmallow roots have a healing effect and soothe the inflamed vocal cords. By drinking the mucous membranes and the vocal cords are moistened and the irritation is alleviated. However, the tea should not be drunk too hot so as not to damage the vocal cords. The consumption of alcoholic beverages should be avoided during the duration of the disease. Even cold drinks are taboo in a vocal cord inflammation, as well as milk due to its slime-forming effect.

Instead of drinking the herbal tea, it can also be used for inhalation. Gurgell solutions also help combat vocal cord inflammation. For this you can use salt water, herbal teas or diluted tea tree oil. Curds of quark have a cooling effect and help to reduce swelling in the inflamed neck area. The cool quark is spread directly on a kitchen towel, the cloth is then wrapped and wrapped around the neck. Warm potato or onion wraps also have a beneficial effect on the inflamed vocal cords.

onion

Onions are among the medicinal plants and are often used because of their anti-inflammatory effect in vocal cord inflammation. The essential oils contained in the onion kill bacteria and accelerate the healing process. For this a raw onion is cut into fine cubes and poured with hot water. At will you can sweeten the brew. Honey is best suited for this because it also has antibacterial and germicidal effects. The brew is now left in the refrigerator for several hours and then it can drink.

Duration of vocal cord inflammation

The duration of vocal cord inflammation depends on the severity of the inflammation. Normally, vocal cord inflammation is harmless and lasts one to two weeks. A slight irritation or overuse of the vocal cords is cured within a few days with protection of the voice. In severe cases, however, it may take several weeks for the vocal cords to heal completely and for the patient to be able to speak again without difficulty. Complications are also possible, which further delay the healing process. These include respiratory distress or high fever, and the transition to chronic laryngitis is possible. In such cases, a doctor must be selected immediately, otherwise it may lead to complete loss of voice.

The disease can also be treated with medication, which can shorten the duration, however, a drug therapy is not necessary in many cases. In severe vocal cord inflammation, which persist for more than three weeks, however, must be a drug treatment with antibiotics, otherwise there is a risk that the disease becomes chronic. With a chronification a treatment is only limited possible and those affected usually suffer from persistent voice problems.

How long will you be on sick leave?

The duration of the sick leave depends on the cause and the severity of the vocal cord inflammation. In acute inflammation, the patient is on sick leave for several days, if the cure is slow, the sick leave can be extended. If the cause of the vocal cord infection is an infection, the person affected will be on sick leave until the infection has healed and there is no longer a risk of infection. The duration of the sick leave also depends on the profession. People who have little to talk about while working can return to work rather than people in linguistic professions, such as teachers or call center staff.

When may I do sports again?

With vocal cord inflammation heavy physical activities and strenuous sports should be avoided. If the cause of the illness is an infection, no sport may be taken during the entire duration of the illness, as otherwise the infection may damage the heart muscle. In the case of mechanical irritation, light sports such as yoga or a walk in the fresh air may be exercised. However, sufferers should make sure that the vocal cords are kept warm and cold air does not worsen the discomfort.

How long do I have to be silent?

In case of vocal cord inflammation the voice needs to be spared the voice. This does not mean, however, that those affected should whisper, as this vocal cords are even more stressed than when speaking. It is best not to speak, if necessary, but speak as normal as possible. The silence should be kept as long as necessary. Usually, after only a few days, an improvement of the symptoms occurs and those affected can slowly speak normally again. It may take several weeks for a vocal cord inflammation to heal completely and during that time the voice should not be overstressed.

forecast

The prognosis of vocal cord inflammation is good. Therapy should be started as early as possible and the vocal cords should be spared as well as possible. Only rarely does damage occur to the vocalis muscle, which occludes the trachea during swallowing and is also involved in voice production. The vocal cord inflammation is like colds contagious, since the virus can be easily spread to other people and the environment by existing cough.

If hoarseness persists for more than 4 weeks and therapy should not help, a doctor should rule out the presence of a tumor or tuberculosis.

Complication: vocal cord nodules

A dreaded complication of vocal cord inflammation is vocal cord nodules, also referred to as crying or vocal cord nodules. These are changes in the vocal folds caused by the previous inflammation. Especially in people who speak a lot and often suffer from inflammation of the vocal cords, the vocal cord nodules often occur. The nodules lead to hoarseness and speech problems. An ENT doctor diagnoses the disease by means of a laryngoscopy . There is the possibility to treat the vocal cord nodules by a speech and voice therapy with a speech therapist. In rare cases, surgical removal of the vocal cord nodules may also be considered. The elevations are removed by microsurgery using a laser.

diagnosis

The vocal cords can be examined via the laryngoscope ( indirect laryngoscopy ). A small mirror is pushed over the open mouth to the rear wall of the pharynx. The doctor can then assess the larynx from above. In direct laryngoscopy, instead of a laryngoscope, an endoscope is used, which is advanced to the larynx. The advantage of this method is that samples can be taken in addition to the examination. This is especially useful if symptoms persist for more than 4 weeks and a tumor should be clarified.

In acute vocal cord inflammation, in both examination techniques evenly reddened and swollen vocal cords are covered with a tough mucus. If it is a chronic inflammation, thickened and reddened vocal folds and a dry mucous membrane, including the larynx. In contrast, the vocal cords of the pseudo-group are only slightly red.

How is a vocal cord inflammation different from a laryngitis?

The vocal cords are part of the vocal cords in the larynx. Overuse of the voice or infection can cause inflammation of the vocal cords. If the pathogens spread to the entire lining of the larynx during an infection of the vocal cords, this is called laryngitis . The hoarseness and coughing gets worse and there are additional sore throat or difficulty swallowing. In rare cases, laryngitis causes respiratory distress and respiratory distress. Mostly both vocal cord and laryngitis are harmless and do not require drug treatment. When infected with bacteria, the doctor prescribes an antibiotic.

Vocal nodules: diagnosis and treatment (July 2020).


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