Vocal Folds: Treatment, Cost and Side Effects

There arise situations where your vocal folds become temporarily damaged. The most common symptoms of damaged vocal folds are hoarseness, breathing accompanied with noise, vocal pitch loss, a tendency to chalk or a cough while swallowing food, drink or saliva, frequents breath while speaking, frequent throat clearing, ineffective coughing, and loss gag reflex. If you feel persistent hoarseness for about two weeks and if you feel voice changes or discomforts it would be advised to consult a doctor. Sometimes injuries in neck or chest, stroke, tumors, neurological conditions, and viral infections become reasons for vocal folds damage. The following tests will be performed to evaluate the extent of vocal folds damage.

Laryngoscopy is one of the methods to analyze your vocal folds. The doctor will use a thin flexible tube known as an endoscope or laryngoscope or a mirror to look at vocal folds. There is another test is named as videostrobolaryngoscopy, which uses a special scope containing a tiny camera at its end or larger camera connected to viewing the piece of the scope. The endoscope being magnifying in nature allows a doctor to view the vocal folds to know the severity of the damage.

1. Laryngeal electromyography the electric current in our voice box muscles are measured in this test. Small needles are inserted into your vocal fold muscles through neck’s skin. They provide information regarding how well you can recover and not on the course of the treatment. This is useful when it is performed between six weeks and six months after noticing the symptoms.
2. Blood tests and scans are the additional tests to identify the cause of the damage. Blood test accompanied with X-rays, MRI or CT scans.

The cause, severity of symptoms and time of noticitreatmentsng the symptoms decide the type of treatment. Bulk injections, surgery and voice therapy are the common course of .

There are situations or cases where you get better without surgery, therefore, surgery is recommended only in the worst cases. Collagen injections are given during the initial three months in case of voice loss and voice therapy is recommended before surgery.

Voice therapy This includes activities, exercises which can strengthen the vocal folds. The aim of these is to get an improved breath control, protects the airway swallowing and improved speech control. This is preferred when there is no need for vocal fold repositioning.
1. Surgery

If symptoms don’t get cured with voice therapy and collagen injections for a long time, surgery may be recommended. The options under surgical treatment are bulk injections, vocal fold repositioning, structural implants, tracheotomy, and reinnervation.

The muscle of vocal folds becomes weak and thin as the symptoms persist. The injections add a bulk and strength to the folds. Laryngologist, specialized surgeon will inject collagen, body fat or improved filler substance to add bulk to the vocal folds. This brings the folds closer to voice box to oppositely moving and functioning vocal cords will make contact with the damaged one while you speak, cough or swallow. It is an option to bulk injection. This is known as laryngeal framework surgery, thyroplasty, or medialization larngoplasty. It involves reposition of vocal folds using an implant.

The repositioning involves moving a tissue from outside of voice box to inward, pushing the damaged fold outward to the middle of the voice box. The impaired fold will get better vibration when compared to the damaged fold. Reinnervation, a process in which a healthy nerve is moved to replace the damaged vocal fold from a different area of the neck. Voice improvement take six to nine months. This is done in combination with bulk injection. When both of the folds are damaged are closely positioned, the airflow in that area will be decreased. This can lead to breathing trouble. In this method, an incision is made an opening is created in front of the neck into the trachea(windpipe). A tube for breathing is inserted, to allow air to bypass the damaged vocal folds.

One who is having symptoms of damaged vocal cords and whose symptoms persist even after voice therapy are eligible for the surgery and treatment. People who have an issue of vocal cords like scratching, paralysis, nodules, polyps, and laryngitis can undergo this treatment.The eligibility for the treatment for the disease can be best diagnosed by the specialist doctor. It is therefore advised that the patient consults the doctor before undergoing any specific treatment. Doctors on examining the conditions shall decide the eligibility for the treatment.

One whose symptoms can be cured by injections or voice therapy. people with severe health problems like neurological or cardiovascular problems are not eligible for the surgery.

Some people tend to develop allergic reactions to collagen injections. if the structural implant is not positioned properly it may require an additional surgery. Sometimes bleeding and swelling occurs in the area where breathing tubes are injected. Other than this there are no major severe adverse effects. There is no age restriction for the treatment. The treatment is safe and guarantees no major side effects in most of the cases.

• Drink plenty of water. Follow the course of medications as instructed by the surgeon.
• Avoid situations where you need to overuse your voice. Try not to speak or sing when you feel hoarseness or tiredness in your voice.
• When you feel sick, take sufficient rest. Extra stress can damage or worsen your voice.
• Avoid screaming and whispering which demands extremes of your vocal range. Stress can be an outcome of speaking either too softly or too loudly.
• Practicing and repeating breathing exercise can benefit you during the healing process. Support your voice along with deep chest breaths. Breath control exercise will be taught and must be followed regularly to aid the healing process.
• Cradling while talking over the phone for an extended period can cause tension in the muscles that extends from head to shoulders especially in the neck.
• Use microphones whenever necessary. Don’t strain your voice.
• Avoid noisy places and talking in and around noisy places.
• Consult a speech-language pathologist and choose a voice therapy. This can help in using your voice efficiently.

Under a certified therapist and proper training, the vocal folds attain their normal state within six to 12 weeks. Proper rest and caution can reduce the healing time. Mild symptoms and medication based treatment get cured in 2 weeks.

Depending upon the severity of the issue, the price of treatment varies. Medications and gargle syrups for mild symptoms and initial treatment are available from Rs 500. The surgery for vocal folds and in some extreme cases where it leads to vocal cord ulcers or cancer will cost you Rs 35000 on an average.

If you follow post-treatment guidelines and voice therapy to its fullest, then you can get the best out of the results. If your vocal folds get overstrained or infected it can affect the results. On the whole, the results are semi-permanent.

Speech therapy, breathing exercises, voice therapy are some of the alternatives to the surgery. There are some injections for vocal folds which can be opted as an option for the surgery. Mild symptoms get cured by voice therapy and breathing techniques.