Laryngeal Diseases - Diagnosis, Treatment, and Prevention

What Are Laryngeal Diseases?

Laryngology is a branch of medicine that deals with disorders of the larynx, which is the voice box of the human body. At the same time, otolaryngology deals with the ear, nose, and throat. The larynx, or the voice box, is in the front of the neck and has vocal cords. The primary function of the larynx is sound production and swallowing. The larynx is the entry for the windpipe and is an integral part of the airway. However, many conditions can affect the larynx. Therefore, doctors in the field of laryngology are trained to diagnose and treat conditions affecting the larynx. These doctors are called laryngologists.

What Are the Diseases That Affect the Larynx?

Many conditions can affect the larynx.

• Non-cancerous vocal cord lesions.

• Cancerous vocal cord lesions.

• Infectious laryngeal condition.

• Inflammatory laryngeal conditions.

• Autoimmune laryngeal conditions.

• Neurologic conditions are affecting the larynx.

• Airway conditions.

• Vocal cord movement abnormalities.

What Are the Factors That Can Affect the Larynx?

The other factors that can affect the larynx are as follows.

• Surgical procedures like thyroid, cardiac, thoracic, spine, and vascular surgery.

• During anesthesia or hospitalization.

• Benign vocal cord disorders occur due to vocal abuse, misuse, and overuse.

Vocal cord disorders due to strain or injury to the vocal cords due to:

• Excessive talking.

• Coughing.

• Smoking.

• Throat clearing.

• Screaming.

• Loud singing and loud talking.

• Consistent vocal cord misuse changes speech function and causes hoarseness. Hoarseness experienced longer than two to four weeks without any cause should be referred to a specialist.

The following disorders are caused by abuse, misuse, or overuse of the larynx.

• Laryngitis: Laryngitis is the inflammation or swelling of the vocal cords.

• Vocal Cord Nodules: Vocal cord nodules include benign, small, callus-like growth and inflammation on the vocal cords. Nodules are the most common non-cancerous pathology. Singers and other professionals who use voice excessively, like teachers or lawyers, risk developing such nodules.

• Vocal Cord Polyps: Polyps occur due to an injury that is after any kind of trauma. These polyps are inflammatory. They occur due to vocal cord injury due to increased demand or consistent coughing. Chronic smokers also risk developing polyp-like changes in the vocal cords.

• Vocal Cord Hemorrhage: Vocal cord hemorrhage can cause a sudden loss of voice. Hemorrhage occurs due to blood vessels rupturing on the vocal cord's surface. This fills the soft tissue with blood. Rest is recommended until the complete resolution of the bleeding.

• Voice Disorders: Certain professions are at high risk of developing voice disorders. These professions include teachers, counselors, customer service, and sales executives.

• Spasmodic Dysphonia: Spasmodic dysphonia is a neurologic condition of the larynx. In this condition, the involuntary muscle contraction or tightening of specific muscles of the larynx occurs. This causes straining, strangling, or intermittently breathy voice.

• Laryngeal Papillomatosis: Laryngeal papillomatosis is a chronic viral infection. Laryngeal papillomatosis consists of benign lesions and wart-like tumors. These lesions grow inside the vocal cords or the respiratory tract from the nose to the lungs. These lesions are caused by the human papillomavirus (HPV). This HPV proliferates and has a high chance of reappearing even after treatment. This shows symptoms like breathing difficulties due to blocked airways or hoarseness due to the lesions on the vocal folds. Laryngeal papillomatosis can be seen in adults, children, and infants.

• Vocal Cord Paralysis: Vocal cord paralysis happens when vocal cords in the larynx do not function well. This is faulty opening and closing of the vocal cords. Vocal cords help talk when air from the lungs is released and goes through the cords. This vibrates the cords and creates sound. Along with speech problems, vocal cord paralysis causes coughing, phlegm in the throat, difficulty swallowing, and shortness of breath. One of the classic symptoms is a breathy and weak voice.

• Vocal Cord Motion Disorders: Vocal cord motion disorders occur after thyroid, vascular thoracic, or spine surgery, long-term traumatic placement of a breathing tube, or after a viral infection.

• Laryngopharyngeal Reflux: Laryngopharyngeal reflux is also called heartburn or gastroesophageal reflux disease. Gastroesophageal reflux is acid reflux that causes a burning sensation in the chest. This feeling occurs after eating, exercising, or lying down. Reflux occurs when the contents of the stomach reverse back into the esophagus. This happens because the lower esophageal sphincter valve controls the passage of food from the esophagus to the stomach. Failure of this valve causes reflux. The classic symptom is heartburn. In addition, reflux affects the larynx and produces symptoms like coughing, hoarseness, inflammation, and sore throat.

• Laryngeal Cancer: Most of the laryngeal growths are non-cancerous. However, some of the tumors can grow in the larynx. The inner laryngeal walls are lined with squamous cells. All laryngeal cancers occur in these cells; these cancers are called squamous cell carcinomas. If not detected early, laryngeal cancer can metastasize to surrounding lymph nodes in the neck. Smokers are at higher risk than non-smokers for laryngeal cancer. Laryngeal cancer is treatable at an early age.

• Laryngeal Stenosis: Laryngeal stenosis is the narrowing of the vocal cord airway due to scarring or vocal cord immobility. These conditions cause problems with breathing. In addition, stenosis can occur due to autoimmune or inflammatory disorders like polyangiitis granulomatosis, prolonged intubation trauma, diseases caused by medical treatment like thyroid surgery, progressive neurologic degenerative conditions, or viral infections.

• Dysphagia: Dysphagia involves difficulty swallowing. Dysphagia shows an inability to swallow solid foods, liquids, or saliva. This leads to malnourishment. Dysphagia causes severe infections due to food entrapment in the lungs or outside the esophagus. Dysphagia occurs when the larynx does not close well during swallowing and when the pharynx cannot move food to the esophagus in a coordinated way. Dysphagia occurs post strokes, neck surgery, or after radiation therapies for cancer.

How Are Diseases of the Larynx Diagnosed?

Diseases of the larynx are diagnosed by a specialist like a laryngologist or an otolaryngologist. Diagnosis starts with a physical exam of the throat and larynx. This requires a scope, a small, flexible tube-like tool, and a camera or mirror to evaluate the throat.

Depending on the symptoms, additional tests can be run. Following are the test that helps in diagnosis.

• Imaging Studies.

• Biopsies.

• Endoscopic examinations.

• Along with the endoscopy, laryngeal electromyography can also be ordered. Endoscopy determines the nerve signal to the laryngeal muscles. It helps diagnose vocal fold function.

How Are Diseases of the Larynx Treated?

The treatment options for laryngeal conditions depend on the diagnosis if the condition occurs due to vocal abuse.

• Rest the voice.

• Voice or singing therapy to recover.

• Therapy by a speech-language pathologist.

• Surgery.

• Radiation therapy.

• Chemotherapy.

• Combination of these therapies.

Particular factors will be considered while choosing the treatment options.

• Medical condition.

• Age.

• Profession.

How to Prevent Diseases of the Larynx?

A few factors will help us prevent diseases and conditions of the larynx. These include:

• Lifestyle changes.

• Quitting smoking and alcohol.

• Not straining the voice.

Conclusion.

Taking care not to strain the voice due to excessive use or misuse can prevent polyps and nodules. Singers, teachers, and lawyers are professionals. Voices can be strained and cause difficulty speaking or singing. Resting the voice, maintaining a healthy lifestyle and physical fitness, and controlling aggravating factors that can harm the voice are necessary. Most conditions affecting the larynx are treatable by the healthcare provider when symptoms are seen initially. However, one must contact the physician if unusual symptoms are seen. Certain conditions can cause permanent damage to the larynx and voice.