Vocal cord lesions screaming boy

Does Your Child Scream So Much That It’s Unhealthy?

Parents probably all agree that their kids scream too much. It’s a child’s warning system, can be an expression or fear or glee and a way to garner attention. Besides the impact on the hearer’s eardrums, is there a point where a screamer can damage vocal chords? The answer is, unfortunately, yes. On the bright side, it’s usually a temporary condition.

Screamers, or singers for that matter, may develop vocal cord lesions, which refer to a group of noncancerous, abnormal growths within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems and are generally seen in three forms: nodules, polyps, and cysts.

Vocal cord nodules are also known as “calluses of the vocal fold.” They appear on both sides of the vocal cords, typically at the midpoint, and directly face each other. Like other calluses, these lesions often diminish or disappear when overuse of the area is stopped.

A vocal cord polyp typically occurs only on one side of the vocal cord and can occur in a variety of shapes and sizes. Depending upon the nature of the polyp, it can cause a wide range of voice disturbances.

A vocal cord cyst is a firm mass of tissue contained within a membrane. The cyst can be located near the surface of the vocal cord or deeper, near the ligament of the vocal cord. As with vocal cord polyps and nodules, the size and location of vocal cord cysts affect the degree of disruption of vocal cord vibration and subsequently the severity of hoarseness or other voice problem.

Surgery followed by voice therapy is the most commonly recommended treatment for vocal cord cysts that significantly alter and/or limit voice. Doctors at the ENT Center of Utah can help determine what procedures are right for you.

A reactive vocal cord lesion is a mass located opposite an existing vocal cord lesion, such as a vocal cord cyst or polyp. This type of lesion is thought to develop from trauma or repeated injury caused by the lesion on the opposite vocal cord. A reactive vocal cord lesion will usually decrease or disappear with voice rest and therapy.

The exact cause or causes of benign vocal cord lesions is not known. Lesions are thought to arise following “heavy” or traumatic use of the voice, including voice misuse such as speaking in an improper pitch, speaking excessively, screaming or yelling, or using the voice excessively while sick.

A change in voice quality and persistent hoarseness are often the first warning signs of a vocal cord lesion. Other symptoms can include:

  • Vocal fatigue
  • Unreliable voice
  • Delayed voice initiation
  • Low, gravelly voice
  • Low pitch
  • Voice breaks in first passages of sentences
  • Airy or breathy voice
  • Inability to sing in high, soft voice
  • Increased effort to speak or sing
  • Hoarse and rough voice quality
  • Frequent throat clearing
  • Extra force needed for voice

The most common treatment options for benign vocal cord lesions include: voice rest, voice therapy, singing voice therapy, and phonomicrosurgery, a type of surgery involving the use of microsurgical techniques and instruments to treat abnormalities on the vocal cord.

Treatment options can vary according to the degree of voice limitation and the exact voice demands of the patient. For example, if a professional singer develops benign vocal cord lesions and undergoes voice therapy, which improves speaking but not singing voice, then surgery might be considered to restore singing voice.

In the end, most of us just need to rest the vocal cords and we’ll all feel better. Speech therapy is usually the next choice for treatment. Even if surgery is required, the specialists at the ENT Center of Utah can diagnose and provide lasting solutions for the issue. To schedule an appointment, please call (801) 328-2522. 

man on plane

Do Your Ears Hurt when Flying?

Many people who don’t normally fly are taking trips for summer vacation during the next few months. For some, an trip via air translates to uncomfortable ear pain. It varies from person to person but usually is most noticeable when the plane descends to land. The pain is worse the lower the aircraft descends in elevation and can be quite acute on landing.

The pain is caused by unequal pressure that develops between the air that is trapped in the middle ear and the air outside the ear. This air space is connected to the back of the nose by a tiny channel called the Eustachian tube. The air on either side of the eardrum should be at the same pressure. As a plane descends the air pressure becomes as you get ready to hit the tarmac. This pushes the eardrum inwards which can be painful. To relieve this, the pressure inside the middle ear has to rise quickly too. Air needs to travel up the Eustachian tube into the middle ear to equalise the pressure.

The Eustachian tube is normally closed but opens from time to time when we swallow, yawn or chew. In most people, just normal swallowing and chewing quickly cause air to travel up the Eustachian tube to equalize the pressure. Many passengers choose to crew gum or suck on hard candy when taking off or coming in for a landing.

However, the Eustachian tube in some people does not open as easily and so the pressure may not be evened so quickly. Consider that some people may have a narrow Eustachian tube than normal and some have conditions — like a cold, infection or hayfever — that causes a blockage to the Eustachian tube. For those passengers, the air can’t travel up the tube quickly enough. Ideally, anyone with a cold, respiratory infection, or ear infection should not fly. However, not many people will cancel their airplane trips for this reason. but, come on, who wants to let a little cold ruin a week or two of fun at some exotic locale.

Here are some tips to alleviate possible ear pain:

  • Suck on hard candy when the plane begins to descend. Air is more likely to flow up the Eustachian tube if you swallow, yawn or chew. For babies, it is a good idea to feed them or give them a bottle upon descent to encourage them to swallow.
  • Breathing Technique Breathe in deeply and try to breathe out gently with your mouth closed while pinching your nose. This way, no air is blown out your mouth while you are gently pushing air into the Eustachian tube. If you do this you may feel your ears go ‘pop’ as air is pushed into the middle ear. This often cures the problem. Repeat this every few minutes until landing or whenever you feel any discomfort in the ear.
  • Do not sleep when the plane is descending to land. If you are extra-tired, ask the flight attendant to wake you when the plane starts to descend. Alert passengers can make sure to try techniques like the sucking or breathing ideas above, and thereby encourage air to get into the middle ear.

What if you have tried all of those tips and you still get pain in the ear while flying?

  • Antihistamine. Take the recommended dose the day before and the day of travel. This may help to limit the amount of mucus that you make. Mucus often blocks the inner ear tubes.
  • A decongestant nasal spray can dry up the mucus in the nose. Try and find one with xylometazoline, like Otrivin. Spray the nose about one hour before the expected time of descent. Spray again five minutes later. Then spray every 20 minutes until landing.
  • Air pressure regulating ear plugs. These are cheap, reusable ear plugs, such as EarPlanes, that are often sold at airports and in many pharmacies. These ear plugs slow the rate of air pressure change on the eardrum. Basically, you put them in before the door of the aircraft is shut. Some people then wear them for the entire flight. Some people take them out when the plane reaches cruising height, and then place them in again just before the plane starts to descend to land.

If the all of these measures fail, rest assured that the pain normally goes away quickly. If not, you can take over-the-counter pain medicine. Fluid sometimes accumulates in the middle ear for a few days after the flight, which may make hearing rather dull for a while. But if it doesn’t soon subside, please see one of our doctors to get treatment.

summer vacation

Health Concerns after Summer Vacation

The end of a “relaxing” vacation can sometimes spell the beginning of health issues. Address them before they build into major health concerns.

That long trip to the beach, that time in the salt or chlorinated water under the sun, dancing on the sand and late night conversations can come back to haunt you once you return your summer vacations. Post-holiday blues may often come from budding health problems as much as the doldrums of regular schedules again.

Dehydration
You experience severe fatigue and loss of energy after a vacation. Resulting from extensive traveling and new food habits, a weakened body may end up as flu or susceptible to new allergies, if not treated on time.

Remedy: Drink a lot of water to keep your body hydrated. Substitute oily food products with fresh fruits and vegetables. Do not bounce back to doing serious work that will tire you easily. If possible, resume your full work schedule after a day or two of adjustment.

Hayfever
This is one of the most common health concerns that people face after a vacation. Perhaps your body got accustomed to the pollution-free air at your dream destination and now finds the balance disturbed back at home. These respiratory concerns like clogging of the nose and a sore throat may be followed by high fever.

Remedy: Treat yourself with home remedies like ginger juice and honey or turmeric. They work better than antibiotics, since it is not a common cold, but a result of sudden change in climate conditions.

Depression
Depression and post-vacation blues usually present themselves as soon as all the fun comes to an end, and you know you will have to get back to the grind. It can also affect you physically. You usually do not catch up on a lot of sleep during vacation during the excitement of seeing new places. This leads to a lack of concentration and an inability to settle down to your routine.

Remedy: Ensure that you catch up on your sleep and recover, both mentally and physically. Do not start unpacking and washing, as soon as you come back, give yourself some time to settle down.