Voice disorders include vocal cord nodules, polyps, vocal cord paralysis, laryngitis, muscle tension dysphonia and spasmodic dysphonia. “The most common voice disorders in Goa are singer’s nodules seen mostly among teachers, singers, politicians and mothers who have young
children to teach,” said Dr Deepak Murty, consultant ENT head neck surgeon, Manipal Goa Hospital, Dona Paula.
Vocal cord nodules are benign (noncancerous) growths on both vocal cords caused by vocal abuse. Over time, repeated abuse of the vocal cords results in soft, swollen spots on each vocal cord. These spots develop into harder, callous-like growths called nodules. These become larger and stiffer, the longer the vocal abuse continues.
Polyps can take a number of forms. They are sometimes caused by vocal abuse. Polyps appear on either one or both of the vocal cords as a swelling or bump (like a nodule), a stalk-like growth, or a blister-like lesion.
INCIDENCE OF VOICE DISORDERS IN GOA
“I see about 100 or so patients in a year with voice disorders” said Dr Murty.
“I was first diagnosed with a vocal cord polyp in 2008. The medications didn’t work. So I underwent surgery for that. I was a lecturer by profession and continued teaching. However, I started experiencing voice problems again and had to give up my teaching career,” said a patient who refused to be named. “I was diagnosed as having early right vocal cord nodule and severe reflux. I underwent speech therapy too. At present, I have been diagnosed with muscle tension dysphonia. Speaking is a challenge for me. I avoid talking much. It’s strenuous and requires big effort to mutter a few words (something which comes normal to people). Talking on phone is a big challenge. I mostly communicate via sms or email. Life has totally changed for me. I am hoping to get back to my old working self.”
SYMPTOMS OF VOCAL CORD NODULES AND POLYPS
Symptoms of vocal cord nodules include hoarseness, breathiness, rough voice, a scratchy voice, harshness, shooting pain from ear to ear, a lump in the throat sensation, neck pain, decreased pitch range and voice and body fatigue.
“Voice strain secondary to job requirements, anxiety, gastric reflux, recurrent allergies are some of the major causes of voice disorders,” said Dr Murty.
DIAGNOSIS AND TREATMENT
Vocal cord nodules and polyps need examination by an ENT surgeon, speech language pathologist and possibly neurologist to rule out neurological causes for the same.
Some nodules disappear on their own and need no medical intervention. Others might require surgical removal. Most polyps need surgical removal. Dr Murty opines, “The solution to voice disorders is treating the cause. Voice rest is important. However, if the problem persists, it’s best to evaluate the case and remove the lesion.”
Speech therapy (learning the correct way to speak) plays a vital role in the treatment of voice disorders but it depends on the severity of the disorder. Certain voice exercises are taught to the patient like phonating (/a/, /e/, /u/) as long as the patient can in one breadth, push-pull exercises (in case of singer’s nodules) and circumlaryngeal manipulation (kind of massage for the facial, neck and shoulder muscles to ease tension to treat muscle tension dysphonia).
Certain precautions need to be taken because vocal cord nodules and polyps recur. Voice abuse which is the major cause can be prevented by avoiding shouting/whispering, avoiding talking in noisy areas, limiting your talking, drinking lots of water to keep the vocal cords lubricated, avoiding spicy foodstuffs which irritate the throat and avoiding too hot/cold drinks/ eatables. If you are a teacher/lecturer, use of microphone is recommended. If smoking is the cause, kick the bad habit. If reflux is causing the problem, lifestyle modifications are a must– eat smaller meals, avoid sleeping for two hours after meal, keep your head at a higher level than stomach while sleeping, etc.
Youngsters encouraged to be Sportspersons
The Directorate of Sports and Youth Affairs felicitated meritorious sports persons and presented the State Youth Award for the year 2009-2010. Prizes were giving for students and educational institutes who participated in sports like football, swimming, diving, rope skipping, double dutch seed, sqay martial arts, taekwondo, rifle shooting, tug-of-war, boxing, baseball, mallakhamb and judo. Lewin Rodrigues and Umesh Guans were awarded the Youth State Award for 2009-2010 while Sarvan Friends Circle and Sports Association, Bicholim were awarded the State Youth Institutional Award. The state level overall championships were awarded in three categories. Don Bosco high school, Panjim won the U-14 Boys and U-17 Boys award while Our Lady of Rosary high school, Dona Paula won the U-14 girls award. St Xavier’s Higher Secondary School, Mapusa stole the show by winning both the U- 19 Boys and Girls category awards for their overall performance. The U-19 Boys award was shared by St Xavier’s Higher Secondary and Kamaxi Educational Society, Ponda. The awards were presented by Ramesh Tawadkar, Minister for Sports and Youth Affairs and V M Prabhu Desai, Director of Sports and Youth Affairs.
Entries open for Samraat Sangeet Sitara
The Samraat Sangeet Sitara 2012 will hold its preliminary rounds from July 14 for its seventh season. Samraat Sangeet Sitara is a talent hunt program for vocalists of Indian classical music singing Hindi, Konkani or Marathi and in the age group of 15 to 25 years. The preliminary round will be held on July 14 at Ponda, July 21 at Margao, July 22 at Panjim, August 4 at Bicholim, August 5 at Mapusa, August 11 at Belgaum and August 12 at Sawantwadi. The semi finals will be held in Margao and the finals in Panjim. Entry forms will be available at all branches of Bicholim Urban Cooperative Bank Ltd.