Dysphonia - what is it? The definition of this term will be given in the materials of this article. We will also talk about the causes of this pathological process, present its symptoms and treatment methods.
Basic information
Dysphonia - what is it? This medical term denotes a qualitative violation of the voice, which is characterized by hoarseness, nasal and hoarseness. If there is a complete loss of voice, then this condition is called aphonia.
Features and forms of pathology
As mentioned above, dysphonia is a change in voice that occurs due to impaired functioning of the vocal apparatus. Such a pathological process can be observed not only in an adult, but also in a child. By the way, there are a lot of reasons for its development. We will talk about them a little further.
According to experts, the condition in question has 2 different forms. Consider their features right now.
Functional dysphonia
This condition is characterized by the absence of any serious pathological changes, as well as inflammation in the larynx. In this regard, functional dysphonia, the treatment of which will be described below, is not a very long process. By the way, various neurotic conditions can contribute to the development of this condition.
There are several types of functional dysphonia. These include the following:
- Hypotonic - characterized by a decrease in muscle tone of the vocal folds, as well as the appearance of rapid fatigue and hoarseness of the voice.
- Hypertonic - characterized by an increase in muscle tone of the vocal folds, as well as hoarseness and sore throat.
- Mutational - manifests itself mainly in boys during puberty. This type of dysphonia is characterized by instability of the voice, as well as a sharp transition from high to low.
Organic dysphonia
This is a pathology that manifests itself as a result of the inflammatory process in the larynx (due to laryngitis, laryngotracheitis). After the extinction of inflammation, dysphonia disappears. This type of voice change is sometimes called transient.
Causes of Dysphonia
The reason for the development of such a pathological condition in children is a congenital defect in the larynx, which consists in the improper development of the cartilage of the larynx, including the epiglottis. Such an anomaly leads to prolapse of the latter, as well as incomplete opening of the entrance to the larynx. This condition is manifested by a jerky and rather noisy breath. In medical practice, this phenomenon is called laryngomalacia, or congenital stridor.
In addition to congenital defects of cartilage, specialists also identify vascular anomalies of the larynx, that is, the formation of angiomas, or the so-called vascular tumors. They arise due to impaired development of the lymphatic and blood vessels in the embryonic period.
The causes of dysphonia can also be associated with underdevelopment or a complete lack of vocal folds. With their congenital dysfunction, the babies show symptoms that are very similar to such signs of bronchial asthma as dyspnea, wheezing and stridor attacks.
It should also be noted that the cause of the development of organic dysphonia is often chronic or acute pathologies of an allergic, inflammatory, oncological or neurological nature in various parts of the larynx or lower respiratory tract.
The main causes of functional dysphonia
Why does functional dysphonia occur? This condition can be triggered by the following factors:
- stressful conditions;
- obstruction, or the so-called violation of the lumen of the upper respiratory tract (due to the ingress of foreign bodies into them);
- diseases of the lungs, heart, endocrine system and blood vessels;
- disturbed work of the sex glands, thyroid gland or adrenal glands;
- the use of anabolics (hormone-like steroid substances);
- anemia, hypo- and vitamin deficiencies;
- a profession associated with the constant use of voice (teaching, vocals);
- diseases of the cervical spine (osteoporosis, arthrosis and others);
- surgical intervention in the neck (that is, with damage to the vocal apparatus of the larynx);
- mental and neurological disorders;
- drug treatment (voice change under the influence of any drugs);
- the consequences of diseases of an infectious nature (slow recovery or irreversible changes in the mucous membrane of the larynx after an acute infection).
Symptoms
Symptoms of dysphonia are associated with a qualitative violation of the voice. In the process of developing such a disease, a person develops hoarseness. He also noticeably changes the timbre or tone.
As for children, this condition is often accompanied by a stridor, that is, a loud and rude sound that occurs when inhaling and exhaling due to the passage of air through the lumen (narrowed) of the larynx.
Diagnosis of the disease
Dysphonia should be treated only after consulting a doctor. To diagnose this pathological condition, specialists must first of all interview and examine the patient. During this, they throw out:
- the nature of the disorder (sore throat, hoarseness, weakness of voice, rapid fatigue, etc.);
- the duration of the pathological process;
- concomitant acute and chronic diseases, against the background of which there was a partial loss of voice (for example, inflammation of the oropharynx of a bacterial or viral nature);
- factors that affect the development of dysphonia (reading aloud, singing, lowering or increasing the tone of the voice , etc.).
Other examination methods
Physical examination of the patient with the development of dysphonia includes the following:
- Examination of (acoustic) voices under load. For this patient, they are asked to read an article, during which they measure the amplitude and frequency of his voice.
- Laryngoscopy is a visual examination of the larynx. This method is the most important and objective. There are several types of laryngoscopy (indirect, direct and microlaryngoscopy). They allow you to evaluate the functionality of the vocal folds, as well as the condition of the mucous membranes of the larynx.
- X-ray and computed tomography of the larynx.
- Densitometry is an assessment of bone density in the cervical spine. Such an examination is necessary to detect osteoporosis or arthrosis.
It should also be noted that due to the many different reasons for the occurrence of dysphonia, the patient needs to be consulted by a number of specialists, including a surgeon, speech therapist, endocrinologist, therapist, phoniatrist, and otolaryngologist.
Laboratory diagnostics
To identify the inflammatory process in the larynx, the patient can be sent to:
- general analysis of blood and urine (to exclude inflammatory phenomena, as well as assess the level of formed elements and hemoglobin in the blood);
- biochemical blood test (to assess the level of hormones of the parathyroid and thyroid glands, adrenal glands, as well as macro- and microelements).
Dysphonia: treatment
How should the disease be treated? The approach to the treatment of dysphonia should be comprehensive. Impact on etiopathogenetic factors is required. In other words, it is necessary to treat not only somatic diseases and somatomorphic disorders, but also foci of chronic infection.
The goal of therapy for this condition is to increase the endurance of the vocal apparatus, as well as the formation of skills of stable phonation.
Most often, non-drug methods are used to treat functional dysphonia. These include phonopedics, articulation and breathing exercises. Collar zone massage, psycho-, acupuncture and physiotherapy are also actively used.
As physiotherapeutic procedures for hypotonic dysphonia, the patient is prescribed electrical stimulation of the larynx muscles by means of diadynamic currents, as well as electrophoresis and amplipulse.
As for mutational dysphonia, it does not require special treatment, with the exception of the treatment of concomitant diseases, phonopedics, and rational psychotherapy.
It should also be noted that with such a pathological process, patients are often prescribed various medications. With hypotonic dysphonia, doctors recommend using stimulants such as the roots and rhizomes of prickly Eleutherococcus, group B vitamins, and neostigmine methyl sulfate. Such drugs improve the microcirculation of the vocal folds and restore a normal voice.
With false-folding phonation and hypo-hypertonic dysphonia, the patient is given local and general anti-inflammatory treatment of hypertrophic laryngitis.
As for the treatment of spastic dysphonia, it is carried out together with neurologists. For this, GABAergic drugs, neck muscle massage, laryngeal muscle blockade and phonophoresis are used.
Surgical intervention
With persistent and severe hypotonic dysphonia, the patient is shown thyroplasty and implant surgery. Their goal is to enhance the adduction of vocal folds. When observing false-folding phonation, which is accompanied by hypertrophy of the vestibular folds, surgical treatment consists in the removal of these pathological sites.
In the postoperative period, in addition to anti-inflammatory treatment, stimulating therapy and phonopedia are carried out, which are aimed at increasing the tone of the vocal folds.
To summarize
To restore a normal voice, some people need to continue phonopedics for several months. If dysphonia occurs in people with voice professions, then they need long-term observation with constant adjustment of the voice load.
Also, the patient should be reminded that a change in voice is a clear sign of a disease of the vocal apparatus. This requires immediate contact with an otorhinolaryngologist. Failure to comply with all the doctor's prescriptions can lead to the formation of pathology of the larynx.