HEALTHNET

How do calluses in vocal cords happen?

Ladies wearing high heel shoes would note areas of thickened skin in their ankles. The same can happen to the vocal cord...

(Posted on 29 December 2006)

Q1. I was told that I have calluses in my vocal cords. How do they happen?

A1. "Calluses" are most commonly formed on the skin when superficial cells are exposed to repeated pressure. Ladies wearing high heel shoes would note areas of thickened skin in their ankles. The same can happen to the vocal cord, which is made of a thin membrane of cells covering two small muscles located within the vocal box made largely of soft bones.

Voice is produced by air being forced out from the space between the pair of vocal cords. The pair of vocal cords is only 18 mm in length in males and 11 mm in females. They vibrate against each other, like strings in a violin, to produce sounds of different pitch depending on muscle tension.

Chronic misuse or abuse of voice causes the vocal cords to close with excessive force. Repeated pressure causes the surface cells to grow faster than usual, forming localized swellings or thickenings on the edge of the vocal cord. Finally a nodule appears, usually one on each vocal cord where the two are touching upon each other. It is more common in singers. That's why they are often called Singer's Nodes. Usually they would disappear after a period of rest. Doctors and speech therapists would work together to help patients learn not to strain their voices.

Q2. My work requires me to talk a lot, how can I protect my vocal cords?

A2. Teachers, singers, presenters or tourist guides who need to talk to crowds of people can damage their vocal cords as a result of chronic abuse or misuse of the voice. In the worse case scenario, this can result in permanent loss of voice that demands a change of career.

Sound production can be improved by training. Singers can improve their performances by proper use of pitch and volume, as well as making use of the breath to support sound production. Conscious effort must be made to relieve tension in the neck and pharyngeal muscles.

How one uses voice is also a matter of habit. One common mistake is for patients to shout louder or cough hard in order to "clear the throat". Such behavior is likely to result in a vicious circle. Patients should avoid cheering, crying or shouting especially in noisy environment and in the open air. They should also learn to lower their voice, talk slowly and avoid making sounds abruptly. Any infection or allergy in the respiratory tract should be adequately treated. Gastroesophageal reflux, if present, should be taken care of since reflux of acidic stomach contents that can irritate the vocal cords. Avoid cigarette smoke (active or passive), environment pollutants (indoors and outdoors) and alcohol that can irritate the throat and the voice box.

Q3. What can parents do to stop their children from shouting? What are the long term implications to the voice?

A3. Encouragement and reward are more likely to succeed than nagging and punishment. Remind him or her to limit screaming, yelling, shouting, and long periods of singing. Praise him/her whenever you notice him or her paying any effort to do so.

Start by creating an environment that is conducive. Avoid situations when children are most likely to abuse their voices, such as playing noisy games in open air or in a background with loud noises. It is also important that the people in the child's environment work to set a good example for the child. Ask the child to walk close to you before talking to you rather than shouting at a distance. Play games with him by "talking with the lips" or use body language to communicate ideas.

If the hoarseness is caused by temporary overuse of the vocal cords, most cases would recover spontaneously after a period of vocal rest. Hoarseness that lasts longer than a few days or that is increasing in severity should be evaluated by doctors. It is also important to note that children with congenital abnormality in the larynx are also particularly vulnerable to attacks of hoarseness after minor overuse of voice.

Source: Quality HealthCare