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Hoarseness - causes, treatment and naturopathy
contents
- definition
- symptoms
- Causes of hoarseness
- Overload of the voice
- Functional and organic causes of the voice disorder
- Neurological causes of hoarseness
- Tobacco and alcohol are poison for the voice
- diagnosis
- Treatment in a hoarse voice
- Naturopathic treatment with hoarseness
definition
Hoarseness refers to a voice disorder (dysphonia). A hoarse voice sounds rough, busy, scratchy to squeaky and loses its tonal power. If the hoarseness increases so much that the voice seems completely flat, physicians speak of an aphony.
Hoarseness is a significant problem, especially for people who have a lot to talk about in their jobs. (Picture: Picture-Factory / fotolia.com) symptoms
Hoarseness shows as a partial loss of the voice, in which not only the vocal power decreases, but also the voice sound is significantly impaired. Those affected increasingly have the urge to clear their throat, but this does not resolve the complaints. Depending on the triggers of the voice disturbance, other symptoms can be observed, which usually give indications as to whether a potentially dangerous illness has been present or whether only the voice has been overloaded.
Symptoms more commonly associated with hoarseness include, for example, sore throat, throat tightness, runny nose, cough, and body aches.
Fever may be associated with hoarseness and may be a serious indication of a more severe disease of the vocal cords or larynx. Swelling and redness in the throat are other possible accompanying symptoms.
Causes of hoarseness
The vocal cords or vocal folds in the upper part of the trachea generate tension in the air stream of exhaling vibrations, from which form the desired sounds in the so-called vocal tract (oral cavity, pharynx and nasal cavity). The height of the notes depends on the degree of tension of the vocal folds. The firmer they are, the higher the tone. The tension of the vocal folds is regulated by the inner and outer laryngeal muscles. The fundamental tone generated in the vocal tract is transformed, for example, by the position of the tongue, the jaw and the lips into the different sounds of the human voice.
Many factors can affect the voice, but a distinction must be made between general articulation and speech disorders on the one hand and hoarseness as a specific complaint on the other hand. A hoarse voice is usually due to impairments of the vocal cords or vocal folds, while, for example, a disease of the tongue causes other forms of articulation complaints.
Overload of the voice
In particular, people who use a lot of their professional voice, such as teachers, market criers or politicians, often have vocal cords. Since they often have to talk for a long time at high volume, the vocal folds are heavily used, hit each other and then appear red and swollen. The swelling of the surrounding mucous membranes makes the voice scratchy and rough.
Occupations that speak a lot and loudly carry an increased risk of overloading the vocal cords. (Image: Thaut Images / fotolia.com) In the long term, recurrent swelling and associated hoarseness may contribute to the formation of so-called nodules on the vocal cords, which are associated with a significant impairment of the voice. In the worst case, this causes an occupational disability of those affected.
Functional and organic causes of the voice disorder
In the case of voice disorders, a fundamental distinction must be made between functional and organic causes. For example, while functional voice disorders can be due to impaired speech habits or the type of phonation, the organic causes of hoarseness are primarily disorders in the vocal tract area. Laryngitis, vocal cord inflammation and throat cancer are examples of these organic triggers.
A hoarse voice often occurs in conjunction with a cold or flu. The triggering viruses also affect the larynx and cause here an acute inflammation of the laryngeal mucosa. The vocal cords are also affected, swell and the voice appears hoarse. As concomitant symptoms are here, for example, cough, runny nose, sore throat and dysphagia to call. In addition to this viral laryngitis, a bacterial infection is also possible as a trigger.
Other potential causes include tissue changes such as vocal cord polyps, cysts, nodules, and granulomas that affect vocal cord vibrations. Neurological conditions such as Parkinson's may be associated with impaired voice. Those affected have difficulty controlling the formation of the sounds. Her voice is indistinct, monotonous and often hoarse.
Diseases of the central nervous system such as multiple sclerosis sometimes show recurrent hoarseness as a concomitant symptom. This applies equally to diseases or damage to the brain. For example, strokes, inflammation of the brain and meninges, brain tumors and brain injuries due to an accident are often associated with a voice disorder.
At worst, the hoarseness is due to a disease of throat cancer. (Image: Sebastian Kaulitzki / fotolia.com) Neurological causes of hoarseness
If the nerves that regulate the muscles controlling the vocal folds are damaged, paralysis of the vocal folds may result, which manifests itself in a constant hoarseness and loss of vocal power. Not infrequently, sufferers also suffer from shortness of breath, as the paralyzed vocal folds block the airflow. In the worst case danger of suffocation.
Corresponding paralysis of the vocal folds is often observed after neck operations such as thyroid surgery. If the inferior laryngeal nerve (also known as nerve recurrence) that is responsible for the control of the internal laryngeal musculature fails, general articulation impairments and corresponding speech problems are often still to be observed.
In rare cases, a so-called aneurysm (artery bulge) leads to voice disorders. In particular, patients with hypertension, arteriosclerosis and connective tissue weakness are at risk here. However, only outlines of the arteries in close proximity to the vocal cords have an effect on the voice. Corresponding aneurysms are often accompanied by a puncture in the chest or chest pain.
Tobacco and alcohol are poison for the voice
In general, smoking and alcohol consumption are said to have an extremely adverse effect on the voice. The toxins in tobacco smoke irritate the vocal cords and damage the nerves. Especially in smokers over the age of 30, smoking often leads to so-called Reinke edema. As a result of the build-up of body fluid, swelling forms below the vocal cord mucosa, and the voice sounds significantly deeper and rougher.
For the women concerned, these acoustic changes in their voice are often extremely unpleasant, especially as they sound slightly hoarse and relatively masculine in the long run. The swelling can in the worst case, the breathing be impeded.
Alcohol has a similarly negative effect on the voice as tobacco. The cytotoxin causes swelling of the mucous membranes, which give a deep, scratchy voice (whiskey voice). Alcohol and tobacco are the main risk factors for malignant tumors in the larynx.
Chronic inflammation in the vocal tract and corresponding hoarseness may also be due to the inhalation of toxic fumes, chemicals, fumes, particulate matter or other pollutants. Persons who are more exposed to such stresses for professional reasons, tend to redness and swelling of the mucous membranes with appropriate hoarseness. Not infrequently, this is accompanied by a chronic irritant cough.
Smoking causes some women's voice to become much deeper and scratchier. (Image: Danny / fotolia.com) diagnosis
On the basis of a first Augenaugen of the ear, nose and throat and a measurement of body temperature usually first indications of the cause. To confirm the diagnosis, the stroboscopy is used, with the help of which the function or the vibration behavior of the vocal folds can be assessed. An inserted endoscope transmits images from the inside of the larynx to a monitor, whereby the vibrations of the vocal cords become visible with the help of targeted light flashes. The procedure is similar to ordinary laryngoscopy and is relatively easy to perform.
However, stroboscopy is not sufficient to determine whether tissue neoplasms are benign or malignant. This may require the removal of a tissue sample. On the basis of blood tests, there may also be further indications of the nature of infections and inflammations in the area of the vocal tract.
Treatment in a hoarse voice
When hoarseness is first urgently needed silence. Those affected should absolutely refrain from talking hoarsely and whispering. In addition, it must be ensured that there is sufficient indoor air humidity. Alcohol and tobacco should be avoided. To moisten the mucous membranes, a high fluid intake, for example in the form of herbal tea is recommended. According to the different causes of the complaints further measures are required, which can range from voice training (speech therapy) to operations.
The proven home remedies for hoarseness, such as warm potato wraps or sage sweets, show a very promising effect on cold-related voice disorders, but are of little help in many forms of hoarseness.
If a cold is the cause of hoarseness, home remedies, such as Sage sweets, serve well. (Image: LianeM / fotolia.com) For example, vocal cord polyps often require endoscopic microsurgical surgery for removal. Even with a cyst surgery is usually required. In particularly severe cases of Reinke edema, an endoscopic microsurgical procedure on the vocal chords is also performed. Often, however, this disease can already be successfully countered with the help of speech therapy. Proper breathing, articulation and posture largely prevent the effects of Reinke edema. Patients should stop smoking.
If infectious diseases such as a cold, flu, tuberculosis or diphtheria are the cause of hoarseness, the treatment of this underlying disease comes first. When the disease is defeated, hoarseness usually disappears.
In the case of neurologically-induced vocal cord paralysis, however, the actual cause of the discomfort on today's medical conditions can often not be remedied. Therefore, if the paralysis persists for more than nine months, surgery is often used to restore normal voice function. Voice or voice training is then an integral part of the therapy.
In the case of throat cancer, surgical removal of the affected tissue with subsequent radiation and / or chemotherapy is usually provided. If the cancer of the larynx is recognized particularly early, chemo and radiotherapy may already be sufficient to achieve a cure. It may be necessary to remove the entire larynx. This results in a total loss of voice for those affected and correspondingly far-reaching consequences. Many are dependent on electronic speech assistance throughout their lives following treatment.
Naturopathic treatment with hoarseness
In naturopathy there are numerous possibilities to treat the different causes of a voice disorder. For example, manual therapies such as rolfing or osteopathy are aimed more at eliminating functional impairments of the voice, while homeopathy, Schüssler salts and active ingredients of phytotherapy (herbal medicine) are used to treat the organic causes of hoarseness.
Essential oils, such as peppermint, lavender or thyme, which are put into a bowl of water for evaporation, can be used concomitantly to relieve the symptoms. Furthermore, a balanced acid-base balance in the naturopathic treatment of various underlying diseases of hoarseness plays an essential role.
Sometimes psychic factors are involved in the occurrence of hoarseness, which is considered according to the holistic approach in naturopathy. For example, the voice may lose its power of excitement or fear and sound hoarse.
If the voice disorders have a corresponding mental cause, a psychotherapeutic treatment is advised. Because the repeated hoarseness can lead to further complaints regardless of their causes. It promotes the formation of nodules, cysts and polyps in the area of the vocal cords and may be associated with significant impairments of the voice outside of the acute phases. People who suffer from hoarseness should therefore not hesitate to seek therapeutic help. (fp, last updated on 17.11.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)