HomeAnswersOtolaryngology (E.N.T)chronic coughWhat could be the diagnosis with chronic cough and hoarseness in voice for a long duration?

After exposed to dry dust, I started getting hoarse voice, and inflamed vocal cords. What can I do?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At July 23, 2020
Reviewed AtAugust 9, 2023

Patient's Query

Hi doctor,

16 months ago, I was exposed to fine dust from dry grinding/polishing of concrete (indoors) where I work. This went on for two workdays. My voice became coarse right away, and a cough started. Now, 16 months later, throat still irritated, voice is somewhat coarse. I have to clear my throat a lot. Still I have some cough. I saw an ENT a year ago, who said my vocal cords are wrong color and inflamed. I am still feeling the effects 16 months later. What do you think? What should I expect? What can I do? Will I get cancer? Please give me you are honest opinion. I am a nonsmoker.

Hello,

Welcome to icliniq.com.

I doubt very much that cancer is high on the concern list. So I would start by addressing gastroesophageal reflux disease since you are of an age when this starts, you have a chronic throat clearing cough (almost diagnostic for GERD), you are a nonsmoker, and have had your vocal cords looked at and no mass or ulceration was seen at the time. Bear in mind, if you follow my GERD (gastroesophageal reflux disease) recommendations and I am correct in the diagnosis, it might take up to four months before your cough and hoarseness resolve. Be patient with the process.

The Probable causes

Age. Eating or drinking anything (even water) two hours before be or during the night.

Investigations to be done

See local ENT if no resolution in four months time.

Differential diagnosis

GERD. Other sources of dysphonia.

Probable diagnosis

GERD.

Treatment plan

Nothing, not even water, two hours before bedtime and during night. Put 4 inch bricks under the two legs at the head of the bed to elevate the head of the bed. This keeps your esophagus uphill from your stomach. Take 40 mg Omeprazole (Prilosec) daily for three months. Take two chewable gums just before going to sleep every night. This is to continue for at least a year or even longer if needed.

Regarding follow up

See local ENT if no resolution after four to five months.

Patient's Query

Thanks, I will try what you suggest. The thing is, the problem began on the same day that contractors began grinding the concrete floors 10 feet from where I work. I worked next to this for 2 days. Had no throat issues before then. They had filtration on their grinding machines, but it does not get ALL the silica dust. I have read that this silica dust stays in the throat/lungs forever. Now I worry what troubles this may cause down the road. My throat feels different, and voice is slightly coarse, and has been since the 2 days of exposure, which is 16 months ago. It worries me that it hasn't gone away, thats why I wanted you're opinion. How much silica dust inhalation does it take to cause damage ? Thank you.

I understand your concern. However, from what I understand, you had two days total exposure and wore a mask. It is doubtful that you got over 50 mcg/day. (To get silicosis, you must have that dose over many, many days as I understand it, not just two days. But I don't know if there is an established "dose " to get silicosis.) Additionally, your main complaint is hoarseness and not pulmonary complaints. A simple chest X-ray at your primary care doctor's office or clinic or through your work would show silicosis, which does have an increased risk for cancer and also tuberculosis. So a simple TB test could also alleviate your fears. As far as cancer goes, the cancer associated with silicosis is pulmonary in origin, not on the vocal cord (the area that would give you hoarseness). The hoarseness persisting despite just 2 days exposure is likely that it was just enough irritation to "kick-off" the hoarseness that was "almost there already" from your GERD...It usually takes longstanding GERD plus some other new factor to initiate the hoarseness...after it gets started, the GERD alone can keep it going. So...treat the GERD and really follow my recommendations and see if it doesn't clear up in the next 4 months or so....

The Probable causes

GERD

Treatment plan

As specified before

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Bruce Eric Hudkins
Dr. Bruce Eric Hudkins

Otolaryngology (E.N.T)

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