Sometimes you go out with your friends, go to a bar with the music very loud, and you can barely exchange three words without making the classic “I can’t hear anything you’re saying” faces. As a result, you end up talking loudly and, surprise!, the next morning you have the same voice as Don Vito Corleone on his daughter’s wedding day.
Hoarseness and the occasional ridiculous noise that can lead many to require the help of a small portable whiteboard to be able to communicate with those around them without having to strain their voice. But this does not have to be the only reason why you barely have a voice coming out, according to Dr. Jordi Coromina, otorhinolaryngologist at the Teknon Medical Center, there are also other reasons.
First of all, we must know that what produces the voice “is the movement of the mucosa of the vocal cords due to the passage of air. This vibration, together with the contact between the vocal cords, which separate to breathe and come together when speaking, produce the sound,” as the doctor explains.
And on the other hand, what we usually call classic hoarseness is “dysphonia” and not “aphonia”, as it is commonly said, which is being left without a voice completely. Below, the possible causes of your “hunter voice”.
Nodules
It is the most common cause and is “calluses on the vocal cords” – like those that occur on the hands when writing – due to misuse of the voice, as Coromina explains. One usually appears on each vocal cord symmetrically, so that when the cords close, they touch each other. Hence they are known as kissing nodules.
We should not fear since they are always benign and appear due to abuse of the voice. Therefore, professions such as singers, radio and television announcers, teachers and other professions where the main instrument is the voice, are more exposed to suffering from them.
It is also common in children, since when they play they tend to shout more. In their case, they should never be operated on because during puberty and with hormonal changes they disappear. In adults, if they are not very big, they can be treated with speech therapy or speech therapy to teach us how to use our voice correctly. “In 90% of cases they disappear with speech therapy, but if they don’t, that’s when surgery has to be done,” says the ENT doctor.
“Even if surgery is performed, we must then go to the speech therapist to teach us how to speak using not only the vocal cords, but also the lungs and larynx,” continues the expert. In addition, nodules are easy to diagnose, thanks to a vocal fold endoscopy, a very simple test that only lasts a few seconds. Something that is complemented with a stroboscopy, which analyzes the undulation of the vocal cords.
Acute laryngitis
This is what we all know as a common cold, caused by a virus, that affects the vocal cords. These, which usually have a pearl tone, become irritated, inflamed and red when faced with a cold. “These types of processes are temporary, they only last a few days and do not require treatment,” explains Dr. Coromina.
Tobacco
This is probably the worst enemy of our voice and not only because it can cause simple hoarseness, but because it can bring with it a worse consequence: vocal cord cancer.
“This type of cancer occurs in 90% of cases in smokers. Although it has a good prognosis, if it is detected in time, because it does not produce metastasis, that is, it does not extend to the lymph nodes in the neck,” says the otorhinolaryngologist. For this reason, the expert emphasizes that “any smoker whose hoarseness lasts more than 15 days should immediately go to a specialist.”
In almost all cases, these cancers are cured completely and without sequelae, thanks to laser surgery and radiotherapy.
Polyps
They are usually like a large benign nodule, but with only one vocal cord. The cause is the same, a person who does not use their voice correctly. “They appear after an acute effort, unlike when it is something more continuous as in the case of nodules. The polyp has to be removed surgically, it does not disappear with phoniatrics,” says Coromina.
Gastroesophageal reflux
Perhaps no one would suspect that behind heartburn could be the cause of hoarseness. But yes, as the expert explains, at night the stomach acids rise up – because we are lying down – and reach the vocal cords, causing irritation and inflammation. “To prevent it from happening, we must treat reflux with omeprazole,” says the expert.
