Learning to look after your voice and to know when there is a problem is particularly important for professionals who make use of their voice in their line of duty.
So whether you plan to be an opera singer, a news presenter on TV, kindergarten teacher, a telecom marketing executive or the next Hong Kong chief executive you will be using your voice extensively every day.
During the past few months I lectured at various Hong Kong universities about voice problems, especially hoarseness.
Our voice is generated from the air we breathe out of our lungs, through the vocal cords, to generate sound. The sound then travels through to our oral and nasal cavities for resonance and articulation from the movement of the tongue and oral cavity mucosa.
Problems along this airway can give rise to voice disorders.
The most common site of voice disorder is the vocal cord. The majority are benign lesions but we also need to exclude vocal cord cancers, which I have already covered.
Common benign vocal cord diseases include Reinke's oedema, vocal cord nodules, vocal cord cysts, vocal cord polyps, glottal gap (bowing of vocal cords) and vocal cord palsy. Most of these diseases will cause a persistent hoarse voice and an occasional shortness of breath when talking.
Reinke's oedema is the swelling of the vocal cords due to increased fluid content. This can occur when there is frequent coughing (vocal cords banging together) from a cold, flu or postnasal drip due to allergic rhinitis.
This can also occur after a big night out from shouting and singing (karaoke). Commonly this malady resolves itself when you rest your voice.
Vocal cord nodules are a thickening of the vocal cord mucosa (surface) due to trauma (the vocal cords hitting each other) and they usually occur on both sides.
These nodules will usually resolve with voice rest, vocal hygiene and speech therapy. They rarely need surgery.
These two conditions usually don't need surgery to recover.
Vocal hygiene means avoiding dehydration (increase oral fluid intake, decrease coffee and alcohol intake as they have a diuretic effect), no shouting and voice rest.
This is recommended in all vocal cord disorders as it helps the vocal cord to rest and promotes healthy healing.
Occasionally, we would prescribe reflux medication as well as this will decrease acid reflux irritation to the larynx (throat).
I will talk more about the other vocal conditions next week.
Dr David Ho is an Australian- and Hong Kong-registered specialist in otorhinolaryngology (ENT). E-mail: email@example.com