Lower voice

Introduction When a normal person presses the thyroid cartilage from the front, the sound becomes low. The laryngeal nerve is derived from the vagus nerve. The node is located close to the jugular foramen and is divided into inner and outer branches on the plane of the hyoid bone. The outer branch is often accompanied by the superior thyroid artery on the way down, usually in front of the superior thyroid artery. If the nerve damage on the larynx can also cause the sound to become low. Lower sound is one of the clinical manifestations of supraorbital nerve injury. Symptoms of unilateral superior laryngeal nerve injury: The frequency range of speech is reduced and treble cannot be performed. Symptoms of bilateral superior laryngeal nerve injury: can not be treble, the sound is monotonous.

Cause

1. Neck trauma: knife wounds, gunshot wounds, etc.

2. Secondary to thyroid surgery: the superior thyroid artery is closely associated with the nerve, so when the upper thyroid artery is ligated, the nerves can be ligated together.

3. Upper laryngectomy, easy to damage the superior laryngeal nerve.

4. Inhalation of harmful gases such as industrial gases, smoking, and chemical dust can thicken the vocal cords. The laryngeal mucosa is dry, thin and bright, and there are often yellow-green or dark brown dry sputum under the sacral area. If the suede is coughed, a small amount of oozing on the surface of the mucosa can be seen. The vocal cords are thin. Its tension is weakened.

5. Infections of the nose, sinuses, and pharynx are also sources of chronic irritation of the throat.

6. The purulent secretion of the lower respiratory tract infection is in contact with the throat for a long time, and is prone to chronic laryngitis. The laryngeal mucosa is diffusely congested, red and swollen, and the vocal cords lose their original white, pink, dull edges, thick mucus on the mucosal surface, often connected to mucus between the glottis.

an examination

Related inspection

Otolaryngology CT examination of oral endoscope

When the unilateral or bilateral superior laryngeal nerve is damaged, it does not cause difficulty in breathing and difficulty in swallowing.

1. History: history of neck trauma or history of thyroid surgery.

2. Clinical manifestations: lack of high notes. Physical examination revealed abnormal glottal morphology.

3. The diffuse congestion of the laryngeal mucosa is visible, the vocal cords lose their normal luster, and they are light red or dark red. They can also see dilated vascular lines, thickened vocal cords, and often secretions in the larynx.

4. It can be seen that the laryngeal mucosa is dark red, the vocal cords are thickened, and the ventricular zone is thickened. Even when the sound is pronounced, the ventricular zone can be covered, and secretions can be seen in the larynx.

5. It can be seen that there are symmetrical knots on the edges of the front and middle 1/3 of the vocal cords on both sides. The color is white, such as the size of the corn, the base is slightly red, and the two vocal cords cannot be tightly closed when the sound is heard.

Differential diagnosis

(a) acute laryngitis

The most common, hoarseness is the main symptom, children with acute laryngitis are heavier than adults, except for hoarseness, and fever. Cough and other symptoms, laryngoscopy, acute congestion of the laryngeal mucosa, edema of the vocal cords and purulent secretions, vocal cord movements are limited to varying degrees, the disease should be differentiated from laryngeal diphtheria and respiratory foreign bodies.

(two) pharyngeal diphtheria

More secondary to pharyngeal diphtheria, hoarseness and dry cough are the first symptoms of laryngeal diphtheria, more common in children, early onset, pronounced rough, gradually aggravated from the snoring to complete aphasia, patients with more than the throat symptoms are more obvious Poisoning, laryngoscopy, see mucosal redness, white pseudomembrane, smear and culture can be diagnosed.

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