Hoarseness (dysphonia) is very common. About one-third of people will have it at some point in their lives. Hoarseness is when your voice sounds raspy, strained, or breathy. The volume (how loud or soft you speak) may be different and so may the pitch (how high or low your voice sounds).
Causes of Hoarseness
There are several causes of hoarseness but, fortunately, most are not serious and tend to go away after a short time. Many are harmless. Using your voice too much. If you talk too long, cheer too loudly, sing too much, or speak in a pitch that’s higher or lower than usual, you may experience hoarseness. Also, your vocal cords naturally get thin and limp with age.
A cold or sinus infection. This should go away on its own within two weeks.
Laryngitis. This is when your vocal folds temporarily swell from allergies, a cold, or an upper respiratory infection.
Gastroesophageal reflux ( heartburn) is when your stomach acids go up into your throat. Sometimes the acids can go as high as your vocal folds, and that’s known as laryngopharyngeal reflux.
Vocal fold hemorrhage. If your voice suddenly disappears, or you can speak but not sing, you might have had a vocal fold hemorrhage. This happens when a blood vessel on a vocal fold rupture, filling the muscle tissues with blood.
Neurological diseases and disorders. If you’ve had a stroke or Parkinson’s disease, your condition may have affected the part of your brain that controls the muscles in your larynx.
Vocal nodules, cysts and polyps. Nodules, polyps and cysts are noncancerous growths that can form on your vocal folds. They form because of too much friction or pressure.
Vocal fold paralysis means that one or both of your vocal cords don’t work properly. One or both might not open or might not close. The cause is usually not known, but sometimes it happens because of an injury, lung or thyroid cancer, infection, multiple sclerosis, stroke, Parkinson’s disease or tumors.
Muscle tension dysphonia. Muscle tension dysphonia is a change in the sound or the feel of your voice due to excessive muscle tension in and around your voice box. This tension prevents your voice from working efficiently. Muscle tension dysphonia is a pattern of muscle use that can develop during laryngitis and remain even after swelling of the vocal cords has gone. It can also be caused by stress and can co-occur with other conditions.
Dysphonia: as a Manifestation of COVID-19
A hoarse voice isn’t a very common symptom of COVID-19. A hoarse voice can sound, and feel, different from person to person. For example, your voice might become more croaky, raspy, or rough, quieter or even change in pitch. If you have a hoarse voice, you might feel like it requires more effort to speak.
The COVID-19 virus affects the tissues in our respiratory system of which the voice box (larynx) is a part of. This explains why some people get a hoarse voice during their infection. While it’s not a particularly strong predictor of COVID-19, if you have an unexplained hoarse voice you should get a test just to be sure.
A hoarse voice can be an early symptom of COVID-19, but its pattern of presentation can vary. Usually, it appears in the first week of illness and builds gradually. For other people, a hoarse voice comes and goes.
On average, a hoarse voice will last two to three days but can last longer in adults (up to six or seven days compared to four days for children).
A hoarse voice isn’t a very common symptom of COVID-19 but the likelihood of having it increases with age. 13% of children, 29% of adults aged 16-35 and 32% of adults aged over 35 experience a hoarse voice during their illness. Only 2% of people who were ill with COVID-19 reported a hoarse voice as their only symptom.
Some COVID-19 patients report their voices going hoarse as the virus takes its course. But that symptom has its roots in other consequences of the COVID-19 virus. Any upper respiratory tract infection is going to cause inflammation of the upper airway. That includes the vocal cords. Laryngitis can occur with any of those viruses.
COVID-19, though, takes that one step further. The virus itself causes inflammation, but it’s a lot of the secondary symptoms that worsen what’s going on.
When an upper respiratory tract infection affects the lungs, like COVID-19, you’re going to be coughing even more. You already have an inflamed throat and vocal cords from the infection and then the secondary coughing that occurs can be quite violent and further irritating.
Coughing can cause inflammation in the larynx. That inflammation affects the flexibility of those vocal cords, making them swollen and stiff. That means they can’t vibrate as much. This can affect the pitch and depth of your voice, causing it to sound raspy or even reducing it to just a whisper.
Steroids
Coughing isn’t the only COVID-19 symptom, though, that can affect your vocal cords and, consequently, your voice. For patients who get COVID-19 and have a more severe case, one of the treatments is dexamethasone, which is a steroid. Steroids, can lead to increased acid reflux which, in turn, causes a direct acid chemical irritation of your throat and vocal cords.
Those who receive steroids, particularly those with other immune issues, can also develop thrush, a fungal infection that develops in the mouth and throat. The infection can reside on the vocal cords, causing additional irritation.
The Vagus Nerve
Three branches of the vagus nerve are involved in voice production: the pharyngeal branch, the recurrent laryngeal branch, and the superior laryngeal branch. Any nerve in the upper airway can be affected by inflammation caused by a virus. COVID-19 might cause damage to the vagus nerve which, in turn, can cause long-lasting damage to the vocal cords.
If the vagus nerve isn’t working well, the vocal cords may not work the way they are supposed to and may stay closed when they should open. That can also cause additional sensations of breathlessness and coughing which perpetuates this cycle of irritation.
Ventilators
A ventilator is a machine that helps you take breaths if you can’t do it on your own. In severe cases of COVID-19, you can be put on a ventilator which can cause issues with your vocal cords when you recover. If you’re put on a ventilator, you already have to deal with the other symptoms plus having a plastic tube go through your vocal cords for up to several weeks in extreme cases. That can cause some lingering vocal cord issues for some time.
Prevention of Dysphonia
Stay hydrated. Vocal fold hydration is maintained by fluid in several water compartments. Systemic hydration refers to fluid within body and vocal fold tissue. Superficial hydration is the fluid lining the vocal fold surface and laryngeal lumen. Clinical interventions aim to increase both systemic and/or superficial hydration to facilitate optimal voice production. Traditionally, patients are counseled to drink at least 8 Cups of water each day and to limit intake of caffeinated and alcoholic beverages to maintain adequate systemic hydration. To increase superficial hydration, patients are advised to humidify inhaled air with nebulizers, humidifiers, and steam inhalation.
Quit smoking and stay away from second-hand smoke. Avoid fluids that dehydrate your body. Avoid spicy foods.
Dry cough receptors promote more coughing which causes more irritation. So staying well-hydrated can keep those cough receptors from being activated. Cough drops , especially menthol ones, numb the nerves of the cough receptors and make your trigger a little less sensitive.
Keep yourself from using your voice for too long. Speak less, speak softer. It’s a more extreme approach, but avoid speaking and avoid speaking loudly. The more you use your voice, especially often and at a loud volume, the more irritation that can occur.
A healthy diet is important across the board, but it also minimizes those acid reflux issues that can worsen the situation in your throat.
Follow the latest news on Google News
