In the morning, a hoarse voice what to do. What to do if the voice disappears for no apparent reason, but the throat does not hurt. Peripheral paresis and paralysis of the nerves that supply the larynx

Lost voice - adults and children often face such a problem, hoarseness is most often accompanied by other characteristic symptoms, which makes it possible to determine the cause. To eliminate hoarseness, drugs, folk remedies, and special exercises are used.

Why is the voice missing?

Why the voice sat down - the main reasons

• intense heat - the mucous membrane dries up, the voice may temporarily disappear;
• cold wind;
• the voice can sit down during a long conversation, especially if the person is nervous, the topic of the conversation is unpleasant for him;
• constant stay in a room with high temperature and low humidity;
• crying, improper breathing during intense physical exertion, thirst;
• temporary numbness occurs against the background of a nervous shock;
• abuse of dry, hard, spicy food, carbonated drinks, coffee;
• in the morning a hoarse voice happens after drinking, prolonged smoking.

From the point of view of psychosomatics, at times the loss of a voice is inherent in clamped people who cannot speak out, the accumulated resentment literally suffocates them.

What diseases cause voice loss

• hypothermia;
• pharyngitis and - develop as a complication of measles, scarlet fever, tonsillitis, with the active growth of staphylococci and fungi in the nasopharynx;
• poisoning with ammonia compounds, chlorine, acetic acid - these substances cause swelling and burns of the mucous membrane;
• heart failure, hypothyroidism;
• fibromas, papillomas of the nasopharynx, cancer of the esophagus or larynx - the voice disappears constantly or periodically for two or more weeks, while the throat does not hurt, there is no temperature;
• aphonia may be the result of syphilis, meningitis, tuberculosis;
• chemotherapy, radiation.

In adults and children, a violation of sound functions occurs after surgical interventions on the thyroid gland, after removal of the tonsils, tracheostomy.

Periodic or sharp hoarseness can occur with central paralysis of the vocal folds, which occurs against the background of a stroke, malignant neoplasms in the brain, after traumatic brain injury, poisoning.

What makes a child lose his voice

• prolonged tension of the vocal cords when screaming, crying;
• if the voice is suddenly hoarse, this may be the result of stress, fright, nervous exhaustion;
• infectious pathologies of the nasopharynx and larynx - laryngitis, tonsillitis, tracheitis, while itching and sore throat, problems with swallowing, the temperature rises;
• damage to the mucous membrane with solid food;
• the presence of a foreign body in the respiratory tract - the situation requires immediate medical intervention, since the child may suffocate;
• long stay in a room with dry, polluted air;
• angioedema - one of the most dangerous manifestations of allergies, the tissues of the larynx quickly increase in size, it becomes difficult for the child to breathe;
• the effect of hormones on the vocal cords in puberty.

Immediate medical attention is required if hoarseness occurs against the background of true or false croup, which develops with diphtheria, herpetic sore throat, measles. Pathology is accompanied by a dry barking cough, wheezing when inhaling, most often occurs in children 2–5 years old.

Which doctor should I contact?

If a tumor is suspected, it is necessary to eliminate the manifestations of allergies.

What to do at home if you lost your voice

If the voice suddenly disappeared or hoarseness, it is unlikely that it will be possible to get rid of the problem in 5 minutes, since it takes time to restore the vocal cords, eliminate inflammatory and infectious processes. But the right medicines will help you quickly cope with the problem. To speed up the healing process, you should use folk remedies and special exercises.

Medical treatment

To restore a broken or hoarse voice, drugs are most often used in the form of sprays, lozenges, rinse solutions with anti-inflammatory, analgesic effects. More serious medicines are used for viral and bacterial pathologies.

• rinse solutions - Chlorophyllipt, Miramistin;
• throat soothing sprays - Oracept, Ingalipt;
• lozenges - Lizobakt, Strepsils;
• means for lubricating the larynx - Lugol;
• antihistamines - Cetrizine, Fenistil;
• antibiotics for laryngitis - Sumamed, Azithromycin.

Chlorophyllipt - solution for gargling

During treatment, it is necessary to ensure complete vocal rest, for several days it is better not to talk at all, even in a whisper, to exclude unrest and stress, to regularly ventilate the room, and to do wet cleaning. With inflammation of the mucosa, you can not eat hot, cold, spicy and salty foods, all dishes should have a soft, puree-like consistency.

How to treat folk remedies

If you urgently need to restore your voice, eggnog will help. Beat 2 yolks with 30 ml of liquid honey, add 120 ml of warm milk, 30 ml of fresh orange juice, a little ground ginger and cinnamon. Beat the whites in a stable foam, add to the main mass. You need to drink the drink warm 2-3 times a day, the next day the unpleasant symptoms will almost completely disappear.

1. Mix 30 g of chamomile inflorescences, calendula, eucalyptus herbs. Brew 1 tbsp. l. collect 20 ml of boiling water, leave for 30 minutes. Gargle with a solution every 2 hours, such a tool helps to cope even with a drunken voice.
2. Peel the fleshy leaf of aloe, mix in equal proportions with honey. In order for the voice to cut through faster, you need to take the medicine 4-5 times a day, 5 g each, the mixture must be slowly absorbed.
3. Well help to soften the throat inhalation - you can breathe steam over boiled potatoes. Or mix 10 g of St. John's wort and oregano, pour 1.5 liters of boiling water, bring to a boil, cool slightly, add 3-5 drops of peach or eucalyptus oil. The duration of the procedure is a quarter of an hour, it should be done one hour after eating, preferably before going to bed.
4. Compress is a quick and affordable way to restore voice. You can use a solution of an equal amount of vodka and water, a cabbage leaf smeared with honey. For maximum effect, the throat should be wrapped with a woolen scarf or scarf.
5. Anise is one of the best remedies for restoring ligaments. Pour 400 ml of boiling water 1 tbsp. l. chopped raw materials, leave in a sealed container for 20 minutes. Drink in a strained form of 50 ml half an hour before each meal. If the child lost his voice, you can drip 3-4 drops of anise oil on a piece of refined sugar.
6. Add 50 ml of fresh carrot juice to 150 ml of warm milk. Drink 100 ml three times a day.

Any warming methods can be used only if the loss of voice proceeds without fever.

Well helps to soften the throat, eliminate unpleasant symptoms alkaline drink - warm milk with soda, alkaline mineral water without gas.

Voice Recovery Exercises

Special exercises will help to quickly cure a broken voice, strengthen the vocal cords, you need to do it daily, you need to continue gymnastics even after illness in order to avoid aphonia in the future.

Simple exercises to get rid of hoarseness:

1. Pronounce the syllable "kyu", lips should be rounded as much as possible. Then stretch your lips, pronounce the syllable "x". Repeat 25-30 times.
2. Take a deep breath, pronounce the sound "m" or "n" into the nose - index fingers should be attached to the wings of the nose on both sides, if performed correctly, vibration will be felt. This exercise relaxes the diaphragm well.
3. Put your hands in the area of ​​the solar plexus, read any text, opening your mouth wide, clearly articulating the vowels. In this case, it is necessary to feel that the sound comes from the abdomen.
4. In any sentence, first say only the consonants, then all the vowels.

Chanting will also help to avoid problems with the ligaments - the syllables “mi-ma-mu” need to be pulled, changing the tone and intonation. But this should be done after recovery, since a heavy load can only aggravate the situation.

Speech is one of the most important functions of the human body. Through speech, a person has the ability to communicate with others, exchange information, express his thoughts and desires. A person who has lost his voice cannot be considered a full-fledged member of society; he is unable to work in a number of professions. The complete loss of the sonority of the voice is called aphonia.

How is voice formed?

Voice- These are sound vibrations that are formed during the forced exhalation of air through the closed vocal folds of the larynx. Voice formation is an arbitrary act, it is regulated by the cerebral cortex, from where signals go to the nerves that regulate the tone of the muscles of the vocal cords.

vocal folds- these are folds of the mucous membrane, protruding from both sides into the lumen of the larynx. Between the layers of the mucosa in their thickness is the vocal cord and vocal muscle. The vocal muscle has its own characteristics: the oblong muscle fibers in it go in different perpendicular directions, as a result of which it has the ability to contract with sound vibrations both in length and width, and vibrations can occur not only throughout the thickness of the muscle, but also its individual parts (halves, thirds, only edges, etc.). This is important for obtaining different sounds.

The vocal muscles are innervated by branches of the vagus nerve - the superior laryngeal nerve, as well as the recurrent nerve (the most important nerve that regulates the tone of the vocal cords). The recurrent nerves (left and right) depart from the vagus at the level of the aortic arch and rise up to the larynx, while bending around the aortic arch (left recurrent nerve), the right subclavian artery (right), pass along the posterior surface of the thyroid gland. Knowledge of the topography of the recurrent nerve is important in order to be able to suggest various causes of unclear loss of voice.

To form the sound of our voice, the vocal folds must be stretched and closed during the passage of a stream of air. Their vibrations in length and width arise, and a sound is obtained, just as sound arises when a stretched string is released.

Therefore, the violation of this process up to the complete loss of voice may be with non-closure or incomplete closure of the vocal folds.

The cause of voice loss can be both a pathology in the larynx itself, and a violation of the regulation of the muscle tone of the vocal folds (damage to the nerves that innervate them, as well as damage to the muscles themselves). In these cases, a sonorous voice will not work, only whispered speech is possible, which arises from the friction of a jet of air against the walls of the larynx and oral cavity.

The main causes of voice loss

a) Pathologies localized in the larynx itself and affecting the vocal cords

1. Inflammatory infectious processes:

2. Toxic swelling and burns:

• Chlorine poisoning.
• ammonia.
• Acetic acid.

3. Allergic edema (Quincke's edema).

• Severe degree of heart failure.
• Decompensated hypothyroidism.

5. Traumatic ligament injuries:

• As a result of intubation during anesthesia or resuscitation.
• after tracheotomy.
• As a consequence of the ingress of a foreign body.

6. Tumors:

• Benign formations of the larynx (fibromas, papillomas, chondromas, etc.)
• Cancer of the larynx.
• Malignant tumors of neighboring organs with germination (most often - cancer of the esophagus)

b) Damage to the nerves that regulate the tension of the muscles of the vocal folds

1. Peripheral recurrent nerve palsy:

• Injury to this nerve after thyroid surgery.
• Compression of the recurrent nerve by tumors of the mediastinum, thyroid gland, enlarged lymph nodes, aneurysm of the aorta or subclavian artery.

2. Central vocal fold paralysis- damage to the nuclei of the cranial nerves in the medulla oblongata, responsible for conducting impulses to the ligaments:

• Strokes.
• Tumors of the brain.
• Traumatic brain injury.
• Intoxication.
• Infections (tuberculosis, meningitis, botulism, rabies, syphilis, etc.)

c) Direct damage to the muscles of the vocal folds themselves

1. systemic myopathy.
2. Some infectious diseases.
3. Overexertion of the vocal muscles.

d) Functional paralysis of the larynx

1. Hysteria.
2. Neurasthenia.
3. Traumatic neurosis.

Consider the most common causes of voice loss.

Acute laryngitis

Laryngitis is an inflammatory process that affects the mucous membrane of the larynx, affecting the vocal folds. Normally, the edges of the vocal folds are thin, stretched, due to this they are able to close tightly. With inflammation, swelling of the mucous membrane occurs, the edges thicken, become uneven, flabby, their closure is disturbed, and hoarseness of the voice occurs, sometimes to the point of complete loss of sonority. The inflammatory secret accumulating in the lumen of the glottis further interferes with the closing of the folds.

laryngitis

The causative agents of acute laryngitis are most often (, parainfluenza, rhinosynthetic infection, adenoviruses), less often - bacterial or fungal flora. The provoking factor is usually hypothermia, drinking cold liquids.

Also, the cause of acute laryngitis can be the irritating effect of dust and gases.

Symptoms

• Dysphonia - varying degrees of voice impairment (hoarseness, rudeness, hoarseness up to aphonia).
• Unpleasant sensations in the pharynx and larynx - there may be pain, soreness.
• An increase in temperature is a variable symptom and is not characteristic of isolated laryngitis.(only as part of a general viral intoxication).

Chronic laryngitis

Chronic laryngitis- persistent inflammatory process in the mucous membrane of the larynx, which leads to persistent, sometimes irreversible damage to the ligaments and voice changes. Chronic inflammation is promoted by unfavorable factors that cause constant microtraumatization of the mucous membrane:

1. Smoking.
2. Professional voice loads.
3. Work in a hazardous workplace with substances that irritate the respiratory tract.
4. Chronic foci of the upper and lower respiratory tract (chronic, bronchiectasis).
5. Gastroesophageal reflux.

According to changes in the mucosa and the clinical course, the following forms of chronic laryngitis are distinguished:

• catarrhal.
• Hypertrophic.
• atrophic.

Chronic catarrhal laryngitis - This is most often laryngitis of smokers. Complete loss of voice with him, as a rule, does not happen. The main symptoms: voice change, hoarseness, dry cough, sputum may be coughed up in the morning.

Chronic hyperplastic laryngitis occurs more often in people whose profession is associated with constant voice loads (singers, artists, lecturers, teachers). With this type of laryngitis, there is a thickening, hypertrophy of the vocal folds, and the growth of various kinds of vegetations. This thickening is usually uneven, the folds do not close completely. One of the varieties of this laryngitis is the rounded formations that form at the edges of the vocal folds - “singing nodules”. It is clinically manifested by a feeling of discomfort in the throat, a feeling of interference in the larynx, a predominantly dry cough, a feeling of fatigue in the larynx during a conversation, as well as dysphonia and aphonia. Symptoms can be present to varying degrees constantly, periodically aggravating.

Chronic atrophic laryngitis is a manifestation of systemic atrophy of the mucous membrane of the respiratory tract and accompanies atrophic rhinitis and atrophic pharyngitis. Such patients are worried about the constant feeling of dryness, itching, discomfort, voice disturbances up to complete loss.

Tumors

Loss of voice can sometimes be a symptom of a formidable disease - a tumor of the larynx that directly affects the vocal folds, or tumors of another localization, compressing recurrent nerve. From tumors of other localizations, it is necessary to note tumors of the thyroid gland, esophagus, mediastinum, lung, as well as metastases to the lymph nodes of the mediastinum.

Suspicion of the malignant nature of the disease should cause a gradual or sudden loss of voice, lasting more than 2 weeks, without signs of a cold.

grades of laryngeal cancer

It is necessary to pay attention to other signs of a malignant course: weight loss, loss of appetite, weakness, fatigue, difficulty swallowing, pain, enlargement of peripheral lymph nodes.

Laryngeal cancer occurs predominantly in men over 40 who abuse smoking and alcohol.

Loss of voice due to damage and compression of the recurrent nerve

In pathophysiology, there is a term "recurrent nerve syndrome" - this is a violation of the voice, sometimes in combination with respiratory disorders (with bilateral damage).

The main causes of recurrent nerve syndrome:

What to do if you lose your voice?

First, it is necessary to clearly know the situations when voice loss can be a symptom of a life-threatening condition or a serious illness in which self-medication is unacceptable.

You need to seek immediate medical attention in the following cases:

• Suddenly, the voice of the child disappeared. In children, quite often, against the background of infectious diseases, it can occur - acute, one of the symptoms of which is loss of voice. Also, inhalation of a foreign body cannot be ruled out in children.
• Sudden loss of voice, accompanied by difficulty in breathing. This applies not only to children, but also to adults.

They do not belong to urgent conditions, but they also require an examination of the situation when the loss of voice develops gradually, without signs of a cold, does not go away for a long time. This can be a symptom of a malignant disease, and self-medication in this case can harm and prevent timely diagnosis.

If you are sure that the loss of voice is a symptom of acute laryngitis, which developed against the background of SARS, after hypothermia or overstrain of the vocal cords (the voice disappeared, but the throat does not hurt and there is no temperature), you can try to take measures to eliminate this symptom.

What can be done at home with laryngitis?

These are universal measures that need to be taken in case of loss of voice due to laryngitis, and which certainly will not harm.

Antibiotics for acute laryngitis are rarely prescribed, only in case of severe course, with high fever, intoxication, with expectoration of purulent sputum. Assigned locally ( Aerosol Bioparox) and inside ( Amoxicillin, Augmentin, Cefalexin, Macropen).

A dry cough causes additional tension on the vocal cords. Therefore, if you are worried about a debilitating dry cough, you can take antitussive drugs for several days ( Codelac, Sinekod, Stoptussin, Libeksin), dissolve lollipops with sage.

Additionally, calcium chloride can be prescribed intravenously, antihistamines, from physiotherapy - UHF on the larynx.

Also, the doctor can carry out intralaryngeal infusions of oils (peach, olive with the addition of menthol or hydrocortisone).

Folk remedies

There are quite effective folk recipes for quick voice restoration:

In chronic laryngitis, local treatment is more actively used: irrigation of the larynx with various drugs using a special laryngeal syringe. Antibacterial drugs (dioxidin, streptomycin), suspensions of glucocorticoid hormones, vegetable oils for softening, astringents (zinc sulfate) are used.

In case of hyperplastic chronic laryngitis, when there are growths of the mucous membrane of the vocal folds, surgical treatment is possible - microendoscopic removal of hypertrophied areas and nodules. Such an operation can also be done using a laser or by cryodestruction.

Persons whose profession is associated with constant stress on the vocal cords (singers, actors, lecturers, etc.) need regular monitoring by phoniatra . This specialist deals with the treatment and prevention of problems with the vocal cords. The phoniatrist not only prescribes medication, but also advises special exercises to strengthen the vocal muscles.

Treatment for voice loss in children

If the child’s voice has disappeared, you should not take any independent measures until a doctor’s examination. The child needs to be reassured as much as possible, and there is no need to carry out any frightening procedures (foot baths, mustard plasters, steam inhalations, etc.). You can give warm drinks, provide sufficient humidification and ventilation of the air in the room.

If the doctor ruled out any serious complications and allowed the child to be treated at home, you need to provide him with maximum comfort, distract him, and prevent prolonged screaming and crying.

Of the distracting procedures for a child, warm baths for the hands, rubbing the chest, back and legs with warming children's ointments are possible. You can give a baby heating pad filled with warm water or a special heating pad toy. Warm frequent drinking continues. Older children can be inhaled with saline using an ultrasonic (silent) nebulizer. Steam inhalation is difficult for children to carry out. It must be remembered that children under 5 years old should not use peppermint oil (and all preparations with menthol), as it can cause.

Examinations for loss of voice of an unclear nature

Consider a situation where the symptoms of a cold have passed, but the voice is not restored. Either the voice disappears periodically, or the deterioration occurs gradually. Sometimes, with a long course of dysphonia, there may be some improvement in the sonority of the voice due to compensatory hypertrophy of the folds of the vestibule. The patient has an imaginary impression of a cure.

It is not necessary to treat "protracted laryngitis" on your own. It requires a thorough and urgent examination to rule out other more formidable diseases.

First of all, this is an examination by an ENT doctor. The doctor at the reception indirect laryngoscopy using a special laryngeal mirror. In this case, you can see the upper part of the larynx and vocal folds. Normally, the vocal folds are pearly white, tightly closed during phonation. On examination, the doctor assesses the symmetry, mobility of the vocal folds, the degree of closure, the condition of the mucosa, and the presence of pathological formations.

Laryngoscopy - a method for examining the larynx

If indirect laryngoscopy reveals vocal cord paralysis, a suspicion of a tumor, the need to take a biopsy from suspicious areas, is prescribed direct laryngoscopy. It is performed both with a rigid laryngoscope and a more modern flexible fibrolaryngoscope under local or general anesthesia. Fibrolaryngoscopy allows you to magnify the image of the organ under study many times over, fix it, and also take a tissue biopsy from suspicious areas.

X-ray of the larynx sometimes gives information about the presence of volumetric formations in it.

CT scan larynx also gives an idea of ​​the structure of the larynx, the presence of tumors and the state of the regional lymph nodes.

In the syndrome of the recurrent nerve of unclear etiology, it is prescribed without fail X-ray of the chest, CT of the chest and mediastinum, ultrasound of the thyroid gland, esophagogastroendoscopy.

Video: why the voice disappears in the program “Live great!”

The problem of losing your voice has probably worried everyone at least once. This is a very unfortunate occurrence. Most often, it is detected in the morning, when a person wakes up and understands that what to treat? The question appears by itself, since the inability to speak leads to great discomfort.

The reasons

If the voice is hoarse, the reasons for this can be very different. The most common of these is inflammation of the mucous membrane of the larynx. They arise as a result of hypothermia of the body (general or local).

Viral infection is another cause of inflammation. First, the infection affects the nasal, oral cavity, and then descends into the larynx and trachea.

Constant overstrain of the ligaments is also a common cause. Which category of people is at risk? More often, the disease occurs in people whose professional activities are related to the work of the vocal cords - these are teachers, singers, actors, speakers, etc.

What else provokes such a condition of the throat? If human activity is associated with production, where one has to constantly inhale harmful fumes, dust, polluted air, this can also lead to a disease of the larynx.

Symptoms of the disease

In addition to the fact that the pronunciation of sounds is difficult, a person experiences a sore throat, in which it is difficult to swallow. Burning, sensation of a lump, dryness, perspiration, fatigue of the voice are invariable symptoms of the disease.

An increase in body temperature is possible, but not always. After some time, a rough cough may begin, first dry, and then with sputum discharge. The patient experiences general weakness.

Osip voice. What to do?

The very first thing is to go to the doctor. Self-medication here is very undesirable. To start taking a course of medication, you need to know exactly the cause of the disease, and, as you know, there are a lot of them. For each individual case, the doctor uses different methods. Incorrectly selected treatment can lead to unwanted complications.

Parents should be given special warning. They should know that if there is anything to treat him, only the doctor knows. It is especially dangerous to self-medicate to restore voice in children under 5 years old. Swelling of the mucous membrane of the larynx can lead to a sharp violation of breathing!

When visiting a doctor, it is only obvious that the voice is hoarse. The doctor does not immediately determine how to treat the disease, since a thorough examination of the patient is needed, and perhaps a more detailed examination.

But a mandatory appointment will be the correct voice mode, in which it is not allowed to speak a lot and loudly. In some cases, the doctor prescribes complete silence. Even talking in a whisper negatively affects the course of treatment.

For the period of the disease, it is necessary to revise the diet. The food should not irritate the mucous membrane, so not too hot and not too cold food is suitable. It is better if these are plant products. During this period, nutrition must be taken responsibly. Dairy products are also welcome. Alcohol, hot tea and coffee, spicy hot dishes are completely excluded from the diet. Smoking is also contraindicated, it exacerbates the development of the disease.

Plentiful drinking is recommended. In this case, mineral water without gas is well suited. Gargling also works well. The solution can be prepared by yourself or bought at a pharmacy. The preparations "Furacilin", "Givalex" and also sea salt in the proportion of 1 teaspoon per glass of warm water are solutions for gargling.

Sprays for the treatment of the throat have a very good anesthetic and anti-inflammatory effect, so they can also be recommended. It is possible that the doctor will prescribe sedatives to the patient if the loss of voice occurred due to stress.

More serious treatment with medications should be started only when it is prescribed by a doctor.

Folk remedies for voice restoration

Traditional healers have many recipes that help in cases where the voice is hoarse. How to treat the patient, life experience also suggests. But the use of these methods requires great caution, since it is undesirable to take any action without consulting a doctor. And yet there are folk recipes that everyone used at least once in their life.

1. Warm (not hot!) milk with honey, eggnog, a warm scarf around the neck is a traditional treatment for a sore throat. Although these treatments are not always effective and appropriate.
2. Hoarseness remover: mix milk and Borjomi in equal proportions, put 2 teaspoons of honey. The drink must be warm.
3. Grind two egg yolks well with sugar, add butter there. Take between meals. Good for hoarseness.

For gargling, inhalation, you can use the following decoction: take 15 grams of elderberry, linden, chamomile flowers, pour everything with a glass of boiling water and leave for 1 hour.

Calendula officinalis is a plant that is often used to restore the voice. Two teaspoons of dried calendula flower petals are poured into a thermos and infused for 2 hours. One third of a glass of infusion should be drunk 3 times a day. Treatment lasts for 2 months.

Voice formation occurs in the larynx due to the closure of the glottis and vibration of the vocal cords. If for some reason this becomes impossible, then the voice will be absent, there will be only the process of inhalation and exhalation, or the voice will be hoarse, hoarse. The vocal cords themselves are small muscle folds located between the pharynx and trachea, they are located in the shape of the letter V and attached to the inside of the larynx, the ligaments are elastic, with pronounced elasticity. When air passes through them, pumped by the lungs under pressure, they close, begin to vibrate, and a sound is born, called our voice. Bass players have thick and long vocal cords, while opera singers have thin and even vocal cords. The human larynx is a tube-shaped organ, it is used by a person when breathing, talking, swallowing. Its outer wall is the cartilage of the Adam's apple, or Adam's apple.

Usually people do not pay attention to such a valuable gift of nature as a voice, taking it for granted, and only when problems arise with it, they begin to appreciate and cherish it. The voice determines gender, mood, voice gives a person the opportunity to communicate, this is the main component of the second signal system, with its help people express their emotions, thoughts and much more. Hoarseness is the inability to speak loudly. Hoarseness of voice occurs when the ligaments are irritated or damaged.

Any pathological changes in the voice are called dysphonias. What makes an adult's voice suddenly hoarse? This occurs when the ligaments themselves are damaged or obstacles appear in the path of sound waves. Causes of an inflammatory nature: a cold, a bacterial infection in the nasopharynx, larynx with the participation of the vocal cords. These are laryngitis, tracheitis, various tonsillitis, acute respiratory viral infections, and earlier also diphtheria, then, in addition to hoarseness and hoarseness, other symptoms of inflammation of the pharynx and larynx develop: malaise, fever, pain when swallowing, a desire to cough, perspiration and tickling in the throat, with follicular purulent tonsillitis, purulent plugs and raids may appear, the throat has reddening of the posterior pharyngeal wall. If a person tries to talk with hoarseness of voice, the situation may worsen for any etiology, because, when receiving a load, the altered ligaments in such cases are deformed and thickened, and the voice itself becomes rough, becomes hoarse, chronic laryngitis can cause hoarseness forever.

There are also non-inflammatory etiologies of voice changes and its hoarseness and hoarseness, these are various spastic dysphonias, i.e. at the same time, the throat does not hurt and does not bother, but the voice is hoarse, and there is no sound. Such weakness of the voice is noted due to incomplete closure of the vocal cords. Spasmodic dysphonia basically has a neurogenic origin, while the vocal cords involuntarily contract, the sounds made vibrate, interrupt, and at the same time, they are squeezed, tense, as if their owner stutters, the person himself cannot control them. In such cases, the microcirculation in the ligaments is impaired. During the work of healthy ligaments, a person contracts them himself, arbitrarily, i.e. he falls silent and speaks easily when he wants to, there is no such arbitrariness here.

Non-inflammatory causes include two types of disorders: in 80% of cases there is an adduction disorder, in the remaining 20% ​​- abduction disorders. The most common spastic dysphonia. In this case, spastic muscle contraction occurs, it lasts for a long time, chronically. Because of such a spasm, the voice either disappears completely, or it sits down thoroughly, but these violations are still functional in nature, there is no organic plaque, the ligaments are not broken in structure, they are without organic changes.

It is distinctive that there is no pain in the throat in such conditions, but the voice sits down. Such functional disorders are treated for about a month, the voice is completely restored. Such disorders are more likely to occur in people by the age of 40, and women are 50% more likely. In this regard, when they were first described at the end of the 19th century. they were considered exclusively a female disease and were called hysterical pharynx, and with the possibility of losing the voice at the same time - hysterical aphonia. The exact causes have not been established to date, but neurogenic disorders of the ligaments may be provoking factors. With them, both hyper- and hypotonicity of the ligaments can be noted.

With hypotonic disorders, there is a decrease in muscle tone, while the voice becomes hoarsely aspirated, the person quickly gets tired, and the upper register in sound is noticeably reduced. With hypertonicity of the ligaments, they are very tense, there is a shrunken voice, but at the same time it is sharp, very hoarse. Both types of disorders occur in an adult for the following reasons:

1. Professional - are noted among representatives of voice professions. At risk are singers, speakers, actors, announcers, teachers with prolonged screaming, talking in raised tones. They often have cases of a dead voice.
2. Psychogenic causes - voice changes can occur in hysterical individuals with neurosis, during sudden shocks, worries or severe fear (before performances, at interviews, exams). Therefore, often a person is offered to drink water and calm down. Often a glass of water really helps.
3. Organic structural disorders. These include congenital anomalies of the vocal apparatus, increased smoking, the occurrence of polyps, cysts, fibromas and other benign neoplasms (more often in men) on the ligaments. When they squeeze blood vessels and nerves, cancer of the thyroid gland, larynx, the symptom of hoarseness appears early, then pain syndrome is added, and the voice disappears completely (aphonia). In the pathology of the thyroid gland, if at the same time there is its hypofunction, and the production of the thyroxine hormone is reduced, fluid is retained in its tissues, leading to swelling of the surrounding tissues, in particular the larynx, while the voice also changes. Edema from the pathology of the thyroid gland is difficult to eliminate and is difficult to treat. Voice problems can be the result of myasthenia gravis, syphilis, rabies, various congenital vascular diseases (aneurysm of the aortic arch, right subclavian artery, any type of stroke), brain stem disorders. With the latter pathology, indistinctness and hoarseness of the voice are noted, it becomes hoarse, dull, the act of swallowing is disturbed, a person may choke while eating, breathing is disturbed, the patient may die from this. Head injuries, autoimmune processes in the body - rheumatoid arthritis, thyroiditis, Sjogren's disease lead to the loss of the ability to speak.
4. Behavioral - often after a long silence, people suddenly notice that their throat is hoarse. This can happen with dry cold air, with various hypothermia, sharp drinking in a gulp of ice drinks in summer, with increased sweating, with allergies, when stenosis and difficulty in breathing occur from exposure to an allergen, with burns (acetic acid, resins, ethyl alcohol in alcoholics), chemical poisoning with reagents such as chlorine, ammonia, fluorine, household chemicals (Domestos, ACE, Prill, Comet, etc.). In these cases, laryngeal edema (Quincke's edema) may develop, up to a fatal outcome. This can happen with dehydration, operations on the larynx (tracheotomy, due to the existing risk of injury to the larynx during this procedure, only conicotomy is now used - dissection of the ligament in the middle of the thyroid and cricoid cartilage), injuries of the recurrent (upper laryngeal) nerve during operations on the thyroid gland. The hoarseness of the voice remains constant after this, with rabies and botulism, paralysis of the recurrent nerve occurs, there is no voice, because the glottis narrows, and the ligaments remain motionless. Behavioral etiology causes voice changes in the form of rattling, creaking, the vocal cords do not close completely, but they have no organic damage.
5. Mutational (appearance of falsetto) - observed in adolescents with age-related breakdown of the voice. The reason is that hormones provoke lengthening of the ligaments, and later, at the end of sexual development, such voice changes disappear on their own, without treatment due to physiology. For 4-6 months in boys, the voice becomes one octave lower and decreases by about 3-4 semitones in girls.

Functional disorders are always reversible, only with their duration, organic disorders already occur, they cannot be corrected, for example, atrophic laryngitis. Adduction disorders are pathologies in which the ligaments are located close to each other, they are overly tense, stretched, and the voice is also strained and unnatural, its sound is hoarse.

If an abduction disorder has occurred, there is an openness of the vocal cords, they are distant from each other, the voice is silent, not just dead, it is airy, the person speaks with difficulty and only in a whisper. These disorders can be with syphilis, tuberculosis, tumors, etc. It can often happen that the voice suddenly appears, for example, when laughing, coughing, singing, then it tenses up again and hoarse. Others may have the idea of ​​pretense or mental inadequacy of such people, but they are absolutely normal, mentally healthy.

During a visit to the doctor, the patient may note that he has been hoarse for a long time and his voice has changed, his throat is hoarse, his voice is intermittent, he trembles when talking, he feels spasms in his throat when trying to speak, the patient will complain of a feeling of fullness in the chest, moreover, this not associated with heart disease. Visually, it seems that the conversation gives the patient excruciating suffering, because at that moment his facial muscles strain and tense up, he wrinkles his forehead intensely, his face shows an expression of effort, he tries to help himself when trying to communicate with his whole body. At the same time, he sweats, blushes from exertion, his neck veins are swollen, but despite all his efforts, it is impossible to make out the speech, it is still unintelligible, whispering, often interrupted. If signs of damage persist for more than 2 weeks, a doctor's consultation is necessary.

The structure of the upper respiratory tract in children has its own characteristics: the vocal cord apparatus is not fully formed, it does not function fully, there is a very good blood supply, the larynx is narrower, as a result of which ligament edema and narrowing of the glottis easily develop. Hoarseness in children is not a separate nosology, but a symptom. The reasons are similar to those in adults, but there are some peculiarities: a mutation in boys at puberty, this process, in the case of physiology, lasts and normalizes within 6 months, and if it continues, an ENT consultation is necessary.

Children, especially small ones, have a habit of dragging everything into their mouths, swallowing seed husks, this can cause a foreign body to enter the larynx, which, if emergency assistance is not provided, can be fatal. The child turns blue, suffocates, loss of consciousness is possible. With inflammation of the larynx in children from 3 months to 3 years, a “false croup” often develops - at night, against the background of temperature, the child suddenly begins to choke, a barking cough appears, edema and stenosis of the larynx develops, breathing is difficult, whistling, in the absence of emergency assistance, it is possible death due to asphyxia, urgent tracheotomy is required. In infants, cysts or papillomas of the larynx are common. The more often the child screams during crying, whim, the more often nodules appear on his ligaments, provoking hoarseness.

After the loud cry of the child, he only needs to be silent, not even to speak in a whisper, since he harms, like a cry, due to the strong tension of the ligaments. Hoarseness in these cases disappears in a few days. It is necessary to exclude products that irritate the mucous membrane of the larynx, to humidify the air of the room. In case of inflammation, in addition to antibiotics, rinse and inhale with warm solutions 3 times a day for 15 minutes, after which do not eat or drink for half an hour. Sprays help well, but they are not used in children under 2 years of age. From the age of 4, absorbable tablets can be used.

Statistics show that with various dysphonias, people do not come to the doctor immediately, but only months and years after the appearance of changes. You need to contact an ENT specialist and a phoniatrist (a specialist who deals directly with the voice apparatus). During the reception, a detailed collection of the patient's history is always carried out, identifying the nature of his work. Non-inflammatory etiology is assessed by screening, when voice work is assessed by hearing, gender compliance, stress tests are carried out. When, after the study, a change in the range of the voice, its timbre is detected, the strength of the vocal cords decreases, hoarseness appears, rapid fatigue from vocal loads, changes in breathing at the same time, impaired clarity and fluency of speech, its intelligibility, this indicates violations of the vocal apparatus. In this case, the patient undergoes laryngoscopy, MRI, CT scan of the larynx, if indicated, a speech therapist should be consulted, but this is rare.

Treatment is determined by the nature of the disease; a feature of the treatment of dysphonia of any etiology is the observance of silence, if the voice is hoarse - be silent. The ligaments should be at rest, this will allow them to be treated with the best effect and reduce the recovery time. In the treatment of non-inflammatory dysphonias, psychotherapy, respiratory therapy, speech and drug therapy are used.

Traditional methods of treating hoarseness: complete rest of the ligaments, do not talk for several days, avoid cooling, make dry compresses on the throat. Drinking should be warm, not hot; for colds, completely eliminate smoking. To eliminate stressful conditions, the use of sedatives, valerian is indicated, it will be good to relax in a warm bath.

Non-drug treatment of hoarseness is considered the most popular in terms of its results in non-organic disorders. First of all, this is phonopedia - special gymnastics for articulation and breathing. In addition, physiotherapy (electrophoresis with Neostigmine, calcium, bromine, amplipulse, diadynamic currents, UVR irradiation, therapeutic carbon dioxide baths, iodine-bromine, galvanic collar according to Shcherbak), massage of the collar zone, exercise therapy, rational psychotherapy, behavioral therapy, acupuncture. A very good way of treatment is to conduct classes with a phonopedist using special methods.

Drug therapy - they use B vitamins, CNS stimulants (Eleutherococcus), Prozerin, Strychnine, Neostigmine for a course of 2 weeks (improves neuromuscular transmission), gamma-aminobutyric acid derivatives will help with spastic dysphonia, use muscle blockade, phonophoresis. Hyperkinetic cases of stimulants do not require electrosleep, antispasmodics, sedatives. Botulinum toxin is very popular today, it is injected in very small quantities into the muscles of the larynx, and it paralyzes and relaxes them, relieves spasm and prevents nerve impulses from passing through. Its action is enough for 3-4 months. When it is ineffective, surgery is used. During surgical interventions, hypertrophied folds are excised, if indicated, thyroplasty is performed, removal of the nerves of the larynx is possible.

Anti-inflammatory therapy. It is necessary to say about the use of folk methods and remedies: they cannot cure inflammation, this requires antibiotics, they can only be used as an addition to the main one in the form of rinses, herbal teas, if you are sure that there is no allergic background. It is pointless to use only herbs and wait for recovery. In case of inflammation, the underlying disease is treated with antibiotics and symptomatic treatment, bed rest is prescribed. A universal medicine that would help everyone equally has not been created at the moment, so you should not use any remedy on the advice and advertising of your friends. Treatment of laryngitis usually takes 1-1.5 weeks. What can not be done with sore throat and hoarseness? Hot drinks, steam inhalations, ice cream are contraindicated. Of the antibiotics, macrolides, cephalosporins and penicillins are most often used, with a viral infection, antibiotics will be useless, only antiviral agents will help:

1. Macrolides - Azithromycin, Sumamed, Homomycin, Erythromycin, Clarithromycin, Roxithromycin, Spiramycin, Rulid, etc.
2. Penicillin series - Amoxiclav, Ampicillin, Ampiox, Augmentin, Panklav, Frenoklav, etc.
3. Cephalosporins - Cefixime, Aksetin, Ceftriaxone, Cefuroxime, etc.
4. Antiviral drugs - Viferon, Ergoferon, Kagocel, Remantadin, Amizol, Arbidol, etc. They have different mechanisms of action, but they are all aimed at destroying the virus.
5. Lozenges with antiseptics - Falimint, Agisept, Grammidin, Septolete, Suprima-ENT.
6. Solutions of antiseptics for local use - Chlorophyllipt, Yoks, Ingalipt, Iodinol, Kameton, Lugol, Miramistin, etc.

In parallel with antibiotics, antihistamines are used to reduce tissue swelling. If the allergy developed suddenly, the stenosis of the larynx increases, the patient must be urgently taken to the hospital, where he will be provided with specialized assistance using the administration of glucocorticosteroid hormones, adrenaline, antihistamines in the form of injections, and oxygen therapy. Resuscitation also includes the introduction of ketamine, atropine, if indicated - tracheal intubation, mechanical ventilation, conicotomy.

For inhalation, eucalyptus and menthol oils are used. Irrigation of the throat with a solution of 5% ascorbic acid gives a good effect.

For various poisonings, the treatment is specific, for neoplasms - surgical, for all other etiologies, the underlying disease must be treated.

Some popular folk remedies:

1. Pour half a glass of warm milk with the same amount of Borjomi mineral water, add two teaspoons of honey. Drink a solution with a temperature of 36 degrees in small sips for 20 minutes.
2. Mogul-mogul: 2 yolks (raw eggs may contain salmonella!) Rub with 1 tsp. sugar, add 1 tsp. butter. Take a quarter of a spoon between meals.
3. Pour 10 g of pharmacy chamomile with a glass of boiling water, bring to a boil in a steam bath, cool to a temperature of 60 degrees, do inhalations.

Prevention measures

The vocal cords need to be strengthened: stop smoking, breathe only through the nose. If there is a curvature of the nasal septum, it is desirable to eliminate them by an operative method. With a curvature of the septum, a person constantly breathes through his mouth, this increases the likelihood of diseases of the throat, larynx and ligaments. It is necessary to harden the throat, but do it correctly. Drink cold drinks in small sips and regularly. You can suck on a piece of ice. You should always humidify the air in the apartment, do not talk on the plane during the flight, because. pressurized air is very dry.

What are the predictions?

If the treatment is not delayed and carried out correctly, then the prognosis is favorable. It is necessary and important for representatives of voice professions to observe voice hygiene, go to special classes and trainings with voice production, it is necessary to eliminate ligament injuries, stop smoking, and humidify indoor air. You should drink the amount of water you need to moisten the oral mucosa, you should be treated and not start a cold. Hoarseness of voice is not an ordinary common occurrence, it must always be treated in a timely manner.

Any changes in the voice will be immediately noticeable both to the patient himself and to everyone around him. Conversations and communication are an integral part of life. If it changes, becomes more deaf, low and hoarse, this phenomenon is called dysphonia. It requires mandatory treatment, but first you need to determine the causes of its occurrence.

Depending on the causes of hoarseness, various other symptoms may also appear. A hoarse voice, the treatment of which must be started immediately, can disturb people of any gender and at any age, starting from infancy.

• Tension of ligaments. Singers, speakers, teachers suffer from such things - all representatives of the "voice" professions, when you have to talk a lot, sing, sometimes raise your voice. Professional singers are aware of this feature and carefully monitor their vocal cords, but an unprepared person can easily break his voice, after which he will not be able to speak at all for some time. In this case, there is only a loss and change in voice, rarely - discomfort in the throat.
• Infection. Some inflammatory diseases of the larynx can cause voice changes (for example,). It is associated with inflammation and swelling. In addition to hoarseness, such unpleasant symptoms of infection appear in the voice, such as a sore throat, an increased body, and a complete inability to speak. If the disease becomes chronic, voice changes may become irreversible.
• Allergic reactions. Swelling of the larynx and voice changes, suffocating - these are serious and dangerous signs of an allergic reaction and Quincke's edema. After this, suffocation may occur due to severe edema. Such symptoms are a signal to seek medical help.
• Tumors and thyroid. Various malignant and benign tumors, growing, put pressure on the ligaments, blood vessels, nerves, disrupting the mobility of the ligaments and causing voice changes. They can appear at different stages depending on the location.

These are the most common causes of hoarseness, but they can also be found in other conditions and diseases, such as burns of the larynx, injuries, hormonal disruptions, diseases of the nerves and blood vessels, etc. Depending on the cause, treatment and procedures to restore the voice are determined.

Treatment

Treatment can be done as an otolaryngologist (a doctor who studies problems and inflammation of the throat) or a phoniatrist (who deals directly with the vocal cords and voice).

Treatment features:

• Whatever the cause of the damage to the vocal cords, a mandatory component of treatment is the observance of silence. Ligaments need rest. This will significantly reduce the recovery time.
• If the swelling of the larynx and vocal cords is caused by a viral infection, antiviral drugs such as Ergoferon, Viferon, Rimantadine, Kagocel, etc. are prescribed. They act in different ways, but they are all aimed at destroying the virus, which is the cause. Some of them act directly on the virus itself, destroying it, others affect the immune system, stimulating the production of interferon. It is necessary to take such drugs strictly according to the instructions, 3 times a day for 4-5 days.
• With a bacterial infection, a wide spectrum of action is prescribed. They are selected by the doctor individually. They need to be taken in a course of 3 to 10 days at a strictly defined time in order to maintain the desired level of the drug in the blood. Improvements will appear by about 3-4 days, but they are not a reason to interrupt the course, otherwise the infection may return.
• The doctor may also recommend topical preparations, lozenges. For example, lozenges Laripront or spray Tandum Verde. These drugs act directly on the larynx, relieve inflammation and speed up the healing process. Also, disinfectants such as Lugol will help restore a hoarse voice.
• If the swelling of the larynx is caused by an allergy, the first thing to do is stop contact with the allergen. Then prednisolone is administered intravenously, which relieves swelling.
• You should be careful with herbal preparations, which include essential oils, eucalyptus, mint and other herbs. They can cause an allergic reaction and only increase swelling.

Treatment for pregnant women and infants

In women, the voice can become hoarse during various reasons, but two are most common: a viral infection and thyroid disease (hypothyroidism). Hypothyroidism negatively affects the health of the mother and child, it must be treated as early as possible. In addition to a hoarse voice, a woman notes fatigue, brittle hair and nails, and swelling. Treatment consists of taking drugs, thyroid hormones. With proper treatment, the voice will soon return to normal.

If a woman has an acute viral infection, it is also important to start treating it from the very first days in order to avoid it. However, most drugs are not recommended during pregnancy. Treatment should be prescribed only by a doctor. Antiviral drugs are prescribed as needed and only those that are safe for the child (Arbidol, Anaferon). Folk remedies can also be dangerous. A solution of soda, Lugol, chamomile is considered safe.

A woman should rest a lot, drink plenty of warm liquids, but avoid swelling.

Babies often cry and loud screams can also make them hoarse. However, if the baby's voice has changed, it should be checked for other symptoms of an infectious disease, more often it is still an infection.

First of all, the child should be examined by a pediatrician. Even if the redness of the throat has not yet appeared, this may be the beginning of a disease that only an experienced doctor can determine. If necessary, he can advise you to take tests.

As a treatment for a hoarse voice, you can use sprays suitable for the child by age, some traditional medicine recommended by a specialist, for example, warm, chamomile decoction, lubricating the throat and mouth with oil. In no case should you treat a child before a doctor's examination with home remedies, such as inhalation over steam, etc. Until the cause is determined, such events can only cause harm., it is desirable to correct them with the help of an operation. People with these curves often breathe through their mouths, which increases the likelihood of diseases of the throat, larynx, and ligaments.

A hoarse voice should not be considered an ordinary safe phenomenon. In some cases, it can become life-threatening. If, in addition to a hoarse voice, there is severe pain, inability to swallow, you should immediately seek help. A tumor in the larynx can block the air supply.

Undoubtedly, the most terrible consequence is asphyxia and death.

AT in some cases, in the absence of proper treatment, tumors can form in the larynx, voice changes become irreversible.