Thick voice

Introduction One of the manifestations of the vocal cord nodules is that the sound becomes thicker. Vocal Nodules is a kind of chronic laryngitis. It refers to the symmetry nodular hyperplasia at the middle 1/3 of the boundary of the vocal cords on both sides, which hinders the closure of the glottis and causes the sound to be low and rough, and even hoarseness. Due to long-term improper use of sound or excessive use of sound. Under the laryngoscope, there are small white bulges in the middle 1/3 of the edge of the vocal cords on both sides. The translucent surface is smooth, and small blood vessels are visible on the base. The vocal cords are blocked when sounding. The main symptoms are hoarseness and dry itchy throat. Vocal cord nodules are more common in occupational users or in people who like to shout and scream. Others call it a singer summary or a teacher summary.

Cause

Due to long-term improper use of sound or excessive use of sound. It is common for boys and adult women who are fond of talking, especially those who use occupational throats, such as teachers in large classes, and high-pitched singers who sing more than their natural sounds.

The first 2/3 segments of the vocal cords are membranous and participate in the vibration of the vocal cords. The posterior 1/3 of the vocal cords are sacral cartilage, and the opening and closing of the sacral door. A dynamic TV laryngoscope can be used to make a detailed observation of the vibration of the vocal cord edge. The position of the vocal cord nodules is mostly at the midpoint of the membranous vocal cords, because it is the highest point of shearing force and shear force per vibration wave, and localized congestion and edema can occur at this point by improper sound or excessive use of sound. In the initial stage, there is a reversible effusion under the mucosa, which can cause epithelial thickening and transparent degeneration of the potential gap to form nodules.

pathology

The vocal cord nodules are mainly in the epithelial layer of the vocal cords. Both vocal cord polyps and nodules can make the vocal cords incompletely audible, resulting in hoarseness and fatigue due to increased vocal cord weight.

The initial knot is soft and reddish, covered with normal squamous epithelium, the matrix is edematous, with vascular proliferation and vasodilation. The mid-term summary is more solid, with fibrosis and hyaline degeneration. Late nodules are pale, epithelial thickening and keratinization, as well as thickening of the spinous cell layer and incomplete keratinization.

an examination

Related inspection

Otolaryngology CT examination blood routine

Modern medicine

1. The voice is hoarse. There is no change in the early bass. When the treble is high, there is intermittent hoarseness, the tone changes, and the vocal is easy to fatigue. Afterwards, the vocalization changes from intermittent to continuous.

2. Early in the middle of the vocal cords, the middle third of the junction edge is mild edema, and there is mucus adhesion, and there is a hanging phenomenon. Asymmetrical reddish punctate edema-like protrusions appeared approximately one month later. In the elderly with the disease, the edema was fibrotic after about 3 months of onset, forming symmetry, smooth surface, white protrusions such as needle tip or corn-sized nodules, and the knots on both sides of the sound were attached to each other to prevent the vocal cords from closing.

Traditional Chinese medicine

The vocal cord nodules are characterized by difficulty in vocalization or hoarseness, so they belong to the category of "sounding" of Chinese medicine. The disease is mostly caused by the loss of speech, too long overwork, injury to pneumatic fire, resulting in qi and blood stasis, turbid condensation.

1. Dialectical basis: difficulty in pronunciation, hoarseness, discomfort in the throat, local vocal cord nodules.

2. Clinical classification

(1) Difficulty in pronunciation, hoarseness, discomfort in the throat, feeling sticky in the throat, cough can not be found, the findings are mostly edema-like, soft, reddish and moist, and the throat mucosa may have mild congestion. The tongue is thin and greasy, and the pulse is flat or slippery.

(2) Difficulty in pronunciation, hoarseness and hoarseness, throat discomfort, check the small white color is hard, the fur is thin, the pulse is flat or the late is blood stasis.

Differential diagnosis

Abnormal sound: When a normal person speaks, the sound is clear and round, full and rich. If the voice of the voice shows dumb, sputum, sand, and hair, it is often a sign of throat disease and other diseases of the body. Abnormal sounds mainly refer to the abnormalities of people's various voices such as voice, crying, humming and nasal polyphony.

The sound becomes low: when a normal person presses the thyroid cartilage from the front, the sound becomes low. A phenomenon caused by a lowering of the laryngeal nerve causing the sound to become lower.

Aging of vocal cords: As people get older, not only will the skin relax, but the vocal cords will also relax and shrink, and the whole sound will feel old. The larynx is an important vocal organ. When the sound is pronounced, the vocal cord is shifted to the midline, the glottis is closed, and the airflow exhales the impact vocal cord from the lungs, and the sound is emitted. After the resonance of the larynx, pharynx, nasal cavity and chest cavity, and the coordination of the lips and teeth, it is issued. Different sounds. The length, thickness, tension and elasticity of the vocal cords play a decisive role in the pronunciation. The laryngeal mucosa of the elderly is atrophy, the nervous system control ability of the larynx is decreased, and the vocal cords are aging. The reduction of the vocal cords and the number of fibers reduces the elasticity of the vocal cord muscles and the exercise capacity is poor. Therefore, the volume becomes small, the pronunciation is weak, the sound quality is degraded, and the sound is lacking. Suppressed.

Pronunciation change: pronunciation change is a pathological symptom of dysphonia, mainly characterized by delayed and abnormal pronunciation, the development speed of pronunciation is lower than the corresponding age, and the speech is unclear or incorrect. The most likely to be wrong are s, z, c, sh, ch, zh, l, m, n, j, x, etc. Some of the above-mentioned similar sounds are replaced by each other, such as the teacher (lao shi) as Laoxi (lao xi) and the grandmother (nai nai) as mai mai. Omit the beginning or middle of the sound of the word, fixedly send some sounds wrong, pronounced or incoherent, mild dysphonic disorder only shows inaccurate or unclear pronunciation, speech can make people understand; severe dysphonia Because the pronunciation is obviously wrong, the words are difficult to understand, but because the damage only occurs at the language level and there is no syntactic structure error, it always makes people feel that a potential sentence is spoken, which is developmental. Differences in language barriers.

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