Swollen vocal cords

definition

The term swollen vocal cords is very misleading and anatomically wrong. Because it is not the vocal cords that swell, but the vocal cords.

The vocal cords themselves consist only of tight connective tissue, which impresses as elastic fibers. They are the continuation of our voice 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. Therefore, they are also paler than the surrounding structures when viewed optically.

Here you can find more information on the subject: vocal cord

In so-called "swollen vocal cords", the vocal muscle or the space between the epithelium of the vocal folds and the voice muscle swells because these structures have a good circulation. In technical terms, this phenomenon is referred to as Reinke edema.

causes

The causes of "swollen vocal cords" are mostly viral infections in the context of a common cold or bronchitis.
The viral pathogen of whooping cough occurs especially in children as a trigger of a swollen vocal fold.

But it does not always have to be infections that affect the vocal cords in their function. Wrong loading of the vocal cords by speaking, singing or screaming can also lead to irritation of the vocal cord.
Above all, teachers or singers are often affected occupational groups.

The result of irritation in all causes is that the vocal folds are inflamed and reactive to increased blood flow with increased fluid retention occurs. The accumulation of fluid in turn causes the opening between the vocal folds to become smaller, thus impairing their ability to vibrate. The resulting symptoms are a changed voice and optionally a difficult breathing.

Learn more here: Inflammation of the vocal cords

Swollen vocal cords due to an allergy

An allergy can also cause "swollen vocal cords". Every allergy triggers an exaggerated defense reaction of the immune system, which manifests itself in an inflammation.
The inflammation is basically possible everywhere.

Typical for "swollen vocal cords" would be an insect bite. Ingestion of insects in the summer from a lemonade jar may cause the sting of a bee or wasp to irritate the mucous membrane of the larynx and lead to rapid swelling due to reactive inflammation. This is often manifested by a rapidly increasing respiratory distress, 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 symptom severity.

Learn more here: Hoarseness due to an allergy

Swollen vocal cords through the stomach acid

Gastric acid enters the larynx area through the eructation of acidic gastric contents. It refers to the backflow of the stomach porridge as so-called heartburn.

If the heartburn is very pronounced, this can theoretically also lead to "swollen vocal cords", since the stomach acid can attack the tissue layer over the vocal cords.
However, it must be a massive regurgitation of stomach contents, as the body has as its own protection the larynx lid over the vocal folds, which lowers when swallowing or belching to seal the airway. As a result, the respiratory tract is completely sealed during the swallowing process and possible residues in the throat area are washed off by the swallowing process.

Acidic contents of the stomach can only reach the vocal folds during inspiration when the throat is open or if it is severely damaged.

symptoms

The main symptom of "swollen vocal cords" is the altered voice.
It can be rough, scratchy, thin or squeaky. Those affected usually notice for themselves that their tone of voice has changed or they find it harder to hold a pitch or volume. This can be explained by the altered vibratory capacity of the vocal cords during exhalation.

If the vocal muscles can only insufficiently change the degree of tension of the vocal cords during speech, then the sound variety can no longer be guaranteed. The stronger a change in the voice, the stronger the vocal folds are affected by the inflammatory process.

The massive swelling shows up in a complete hoarseness. In addition, some feel a compulsion to clear their throat or to cough more often.

Learn more here: hoarseness

If it is a viral infection, symptoms of a typical cold can be observed. Patients then complain additionally about a nasal obstruction, increased sneezing and nasal discharge. Also fever and body aches can occur.

Swollen lymph nodes in the neck and head are typical as an accompanying reaction of the inflammation.
Read more here: Lymph nodes are swollen - How dangerous is that?

hoarseness

Hoarseness is a symptom of massive "swollen vocal cords".
The swelling can be explained by an enormous accumulation of fluid in the space between the epithelium over the vocal cords and the vocal muscle. The swelling narrows the lumen of the airway and obstructs the vocal folds during opening and closing. If the vocal folds can not be functionally strained for speech production due to the swelling, the air simply flows past the vocal folds and no sound can be generated. The result is hoarseness.
Here you can find more about hoarseness

Hoarseness should not be equated with whispering. Whispering is a deliberate change in the tone of voice, whereas hoarseness can not be arbitrarily changed by the affected person.

diagnosis

The diagnosis of "swollen vocal cords" is best made by the ear, nose and throat specialist using indirect laryngoscopy.
For this, the examiner is asked to stretch out his tongue with his mouth open, so that the doctor can hold a mirror in the back of the mouth. By alternately breathing and saying "hiii", the examiner can then judge both the visual appearance of the vocal cords and their vibratory ability.

The swollen the vocal cords are, the less the vocal cords can be stretched and deflected by the muscles. And the more pronounced the swelling of the surrounding mucous membrane of the larynx, the narrower the opening for the airflow of a breath.

In addition, voice production can be tested by speaking through words and the lymph nodes in the neck and head can be examined for swelling.

duration

The duration of swollen vocal cords is heavily dependent on the patient's involvement in the treatment. Who consistently protects his voice and his body, should not suffer more than about a week under a changed voice. Also, the symptoms of cold in a viral infection of the respiratory tract should improve at this time.

If those affected do not spare their voice, the regeneration time is prolonged and chronic damage can be caused. A long-lasting inflammation can namely lead to scarred remodeling processes and thus permanently impair the ability to vibrate the vocal folds.

Therefore, any perceived hoarseness should be clarified by a doctor - preferably an ear, nose and throat doctor - after seven days at the latest.
If so-called crying nodules (vocal cord nodules) have formed on the vocal cords due to incorrect loading of the vocal folds, it can take up to weeks for them to recede. In individual cases, however, an operative removal may be necessary.
Read more about: vocal cord nodules here

therapy

Swollen vocal cords are primarily treated by a gentle treatment. For the person affected, this means speaking as little as possible and not unnecessarily straining the vocal cords.
Ideally, smokers should also abstain from smoking.

No talking does not mean whispering instead. The whispering aggravates the swelling of the vocal fold, since this pitch is the most stressful for the vocal cords.

In the case of a viral infection, a physical sparing with the measures already described makes sense, in order not to further weaken the immune system. To alleviate symptoms such as hoarseness, decongestants and anti-inflammatory drugs can be given, which, depending on the preparation, can have a simultaneous analgesic effect.

Antibiotics are not indicated in the case of a viral infection because they only act against bacteria but not against viruses.
Local measures such as inhalation with saline may be made as needed.

The aim of the treatment of swollen vocal cords is to control the swelling well. In the worst case, the swelling may lead to airway obstruction, as evidenced by a rapidly increasing respiratory distress. It is important to prevent this emergency by trying to lull the respiratory tract in case of conspicuous breathing noises or difficult breathing work. Therefore, every affected person should be informed about this possible complication and in an emergency, do not be afraid to call the ambulance or go directly to a hospital.

If the cause of swollen vocal cords is due to a false loading of the vocal structures, the therapy consists of vocal and breathing exercises by a speech therapist.

home remedies

As a home remedy for swollen vocal cords have hot drinks and keeping the neck warm with towels or scarves proven.

In general, a sufficient fluid intake is highly recommended to protect the mucous membranes from drying out.
Somewhat critical is the addition of lemon in hot drinks such as tea, as the acid may additionally irritate an inflamed mucosa in the mouth and throat area. The type of tea should also be chosen carefully due to the acidity. Low-acid and anti-inflammatory varieties such as sage or chamomile tea are recommended.
A simple alternative to lemon is the addition of honey.

But also the sucking of sweets is good for the moistening of the mucous membrane, by stimulating the production of saliva. Homemade onion juice can also bring about an improvement, but is not superior to other home remedies and is rarely drunk because of its strict taste. The onion juice itself has a slight anti-inflammatory effect.

Chronic swollen vocal cords

Chronic swollen vocal cords are usually caused by an incorrect loading of the voice-forming structures in the larynx. Frequently affected occupational groups are educators, teachers or singers, but can in principle occur with anyone.

The reason for the swollen vocal cords may be a wrong speaking, too much screaming or a wrong breathing while speaking.
In many cases, the cause is an unconscious ingestion of another pitch, which is more stressful for the vocal cords due to a greater tension. Also, the vocal muscles are overused by the permanent tension.

As a result, the tissue layer on the vocal cords and the mucous membranes on the larynx may become inflamed. If the inflammation lasts longer than a few weeks, there is a risk of cicatricial remodeling processes that can permanently affect the voice. Namely, they limit the vocal cords' ability to vibrate by replacing elastic fibers with rigid, rigid fibers. It could be, for example, that the person concerned keeps a thin voice permanently.

Learn more here: Laryngitis

In addition or as an alternative to inflammation, however, so-called crying nodules may also form directly on the vocal cords. Their origin is due to the increased friction of the vocal cords together by, for example, singing in unusually high pitches.
The nodules then rub both on the other vocal cord and swirl the breathing air for voice training, which provides for a different voice. Patients should be advised by an ENT specialist about possible therapies.
They usually require the speech therapy treatment by a speech therapist and in some cases small surgical interventions on the vocal cords.

Malignant processes are very rare on the vocal chords, but should be clarified by a physician for weeks lasting hoarseness course.


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