Vocal cord hypertrophy

Introduction Vocal cord hypertrophy, also known as chronic hypertrophic vocal corditis or chronic proliferative vocal corditis, and the throat chamber activity or over-representation instead of vocal cords refers to the wide or local volume of vocal cords due to various factors.

Cause

The main reasons for its formation are as follows:

(1) Improper vocalization and excessive vocalization: singing near the shouting mode, frequent shouting due to business needs or personality and living habits, and excessive use of sputum, etc. Damaged, a little longer, tissue damage and hypertrophy in the damaged area. According to the physics principle, the vocal cord vibration touch during the vocalization is mainly in the middle of the vocal cord, so the vocal cord damage caused by improper vocalization and excessive vocalization leads to tissue hyperplasia and hypertrophy, mostly in the middle of the vocal cords, up to the free edge of the vocal cords.

(2) Air pollution: In some factories (such as the chemical industry, the dust industry, and industries that use natural gas as fuel or raw materials), the air contains a large amount of various chemicals and various harmful gases; some work and rest places There are many smokers, and a large amount of harmful substances such as nicotine and tobacco tar are exhaled; some kitchens have poor exhaust gas, and the air contains a lot of harmful substances such as sulfur; in some high-temperature workshops, the air is hot, too dry, and the air humidity is extremely small. The above-mentioned harmful substances, harmful gases, or high-heat dry gas are sucked into the respiratory tract. Over time, the vocal cord mucosa and even the submucosal tissue are damaged, and lesions and tissue hyperplasia occur.

(3) Excessive tobacco and alcohol: A large number of scientific experiments and investigation reports at home and abroad have proved that smoking has a serious impact on the vocal cords and respiratory tract. The smoke produced by tobacco combustion contains various harmful substances such as nicotine and carbon monoxide; when the smoke burns, the temperature is as high as 500 ° C or higher, and the distilled tar and nicotine are very toxic, which can make the vocal tract of the larynx sinus and blood flow slow. The blood supply is reduced, causing lesions in the mucosa of the larynx and vocal cords, and tissue hyperplasia occurs. In people who smoke excessively, the lesions are heavy. Various wines contain different concentrations of ethanol, high concentration of spirits, containing ethanol concentration between 50% and 60%, long-term polydipsia, larynx and vocal cord vasodilation, vocal cord congestion, use of sputum in long-term hyperemia, vocal cord mucosa Damaged lesions, a considerable number of cases are proliferative lesions.

(4) recurrent episodes of acute laryngitis: vocal cord mucosa in acute inflammation, inflammatory lesions such as vasodilation, congestion, exudation of fluid, swelling, cell destruction, etc., must take some time to recover, even if timely treatment, must Experience a process of recovery; if the treatment is not timely, or if the treatment is not appropriate, it will delay the day and will not be able to heal. In the case of acute inflammatory lesions not fully recovered, acute inflammation occurs again, the degree of inflammatory lesions will be aggravated, and the healing process will be prolonged. Such repeated acute vocal cord inflammation can lead to chronic inflammatory lesions of the vocal cord mucosa, and a considerable number of cases have mucosal tissue hyperplasia.

(5) Chronic inflammation of the respiratory tract: suppurative inflammation of the nasal cavity, sinuses and nasopharynx, or chronic inflammation of the respiratory mucosa below the glottis, the inflammatory lesions can spread to the vocal cords; the purulent secretions of these parts reach through coughing The vocal cords also stimulate the vocal cord mucosa. For a long time, it causes chronic lesions of the vocal cord mucosa, including proliferative lesions.

(6) Effects of systemic chronic diseases: systemic diseases such as rheumatism, rheumatoid, chronic hepatitis, chronic nephritis, heart disease, diabetes, and endocrine dysfunction, which can cause dysfunction of larynx and vocal cord vasomotor function, leading to vocal cord mucosal tissue Hyperplasia.

an examination

Related inspection

Otolaryngology CT examination

The vocal cord hypertrophy is mainly characterized by hoarseness. At the beginning, it was Mao and Yu, and later developed into sand and sputum; the initial stage was intermittent, and then developed to be sustainable. In addition to snoring, the throat often has various discomforts, such as foreign body sensation, itching, dryness, burning sensation, pain, and abnormal feeling such as stagnation. And there are dry cough and sputum phenomenon. Under the laryngoscope, the vocal cord mucosa is hyperemia in the early stage of the lesion, red, swollen, dull, and visible secretions.

In the late stage of the lesion, the vocal cord mucosa is rough, dry, and the color is gray-blue or gray-yellow. The central or middle anterior part of the vocal cords has a regular curved arc-shaped bulge or a broad-based tapered protrusion, and multiple bilateral vocal cords occur simultaneously. Both sides are raised or raised. In a few cases, the central vocal cord hypertrophy is not on the free edge but above the vocal cords. The vocal cord hypertrophy is slightly harder.

Differential diagnosis

It should be differentiated from vocal cord paralysis: paralysis of vocal cord or throat paralysis is a clinical manifestation, not an independent disease. When the motor nerve (throat recurrent nerve) of the larynx is damaged, there are three types of paralysis: vocal cord abduction, adduction, or muscle tension relaxation. Clinically, due to the longer stroke of the left recurrent laryngeal nerve, the left vocal cord paralysis is more common.

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