Check-up

I noticed my voice has become hoarse over the past couple of weeks but thought perhaps I was just coming down with a cold

I noticed my voice has become hoarse over the past couple of weeks but thought perhaps I was just coming down with a cold. However, a friend has suggested I may have polyps. What are these and how would I have got them?

The vocal cords lie at the back of the throat and when relaxed they normally form a V-shaped opening that allows air to pass through to the trachea (wind pipe). During speech, the cords open and close when swallowing. The vocal cords can develop a range of problems, such as polyps, nodules, ulcers or paralysis. Nodules and polyps develop mainly from abuse of the vocal cords brought on by prolonged or unaccustomed singing or shouting. It can also occur as a result of chronic irritation of the larynx (voice box) from smoke inhalation from cigarettes or industrial fumes or from the reflux of stomach acid at night. Symptoms of nodules and polyps include chronic hoarseness and a breathy voice, which tends to develop over days or weeks.

I've just started work as a primary school teacher and have been using my voice more than usual since the start of September. I'm also in charge of the school choir. As this is most likely the cause of my problem, do I need to see a doctor?

A definitive diagnosis can be made only by a doctor examining your vocal cords. He may also wish to take a biopsy (a sample of the growth sent for examination under a microscope) to rule out any other disorders. Nodules and polyps are similar non-cancerous growths, with polyps tending to be larger and protrude more.

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How can polyps be treated?

Identifying and avoiding the cause of your problem is the first step in managing the condition. Treatment consists of avoidance of the irritant (shouting, singing or smoke inhalation) and resting the voice. If acid reflux is suspected, then treatment with an antacid and raising the head of the bed may help.

Most nodules go away with conservative treatment but polyps usually require surgical removal to restore the voice completely. As a teacher, it will be impossible to avoid speaking or raising your voice, so you should consider seeking the advice of a speech and language therapist, who will be able to advise you on how best to speak or sing without straining the vocal cords.