|
Symptoms of Vocal Fold Scarring
Mucosal Wave
Wave-like motion of the vibrating layer of the vocal fold as seen upon slow motion-like viewing through stroboscopy
Stroboscopy
Laryngoscopy
with synchronized strobe light that provides a slow motion-like view of
vocal fold vibration (mucosal wave); stroboscopy is the key tool used
to analyze vocal fold vibration
What are the symptoms of vocal fold scarring?
Hoarseness is the most common symptom associated with vocal fold
scarring. Hoarseness causes the voice to decrease in pitch and to
become rough and raspy.
Greater Effort to Produce Voice
Vocal fold scarring causes poor or reduced vocal fold vibration. To
vibrate and produce sound the scarred, stiffened vocal folds demand
greater effort from the entire voice production mechanism (lungs and
muscles of the throat). Patients often complain that they have to work
harder to produce voice. Talking softer or louder, or over background
noise may be more difficult. (For more information, see Anatomy & Physiology of Voice Production.)
Difficulties with Singing and Pitch Control
Vocal fold scarring limits ability to change the pitch, nature, and
volume of the voice during speech and/or singing due to the stiffened
vocal fold. Patients complain of an inability to control pitch,
decreased pitch range and frequent pitch breaks during voice use. This
is referred to as voice instability during pitch transitions, such as
when a singer changes the song pitch from his or her chest voice to his
or her head voice.
Because producing voice may take more energy, the voice tires more
easily. A patient may feel too tired to talk unless it is absolutely
necessary.
How does the patient notice vocal fold scarring?
Since vocal fold scarring develops gradually, patients will
typically notice voice changes over time. The singer or speaker will
notice difficulty "warming up" the voice or a slow decline in voice
quality, such as:
- Change in roughness
- Change in pitch
- Gradual increase in effort used to speak
- More frequent voice fatigue
When vocal fold scarring occurs after either intubation or external
trauma to the larynx, patients complain of hoarseness that does not
completely resolve with time and/or rest.
Often, a common cold lifts but hoarseness does not. If hoarseness
persists for two weeks or longer after the common cold lifts, a voice
disorder, such as vocal fold scarring, is likely.
|
