What is laryngology?
Laryngology is a branch of medicine that deals with
illnesses and injuries of the larynx, often called the voicebox. Laryngology also
deals with voice disorders and treatments. The larynx sits in the neck and
houses the vocal cords. The larynx is vital in the body's production of sound.
What does a laryngologist do?
A laryngologist is a doctor with a special interest in
voice disorders and diseases of the larynx. Laryngology is a subspecialty of
otolaryngology, which refers to the treatment of the ears, nose, and throat.
Otolaryngologists and laryngologists are often referred to as ENT (ear, nose,
What are some of the diseases that affect the larynx?
Some of the most common diseases to affect the larynx are:
Disorders caused by vocal abuse, misuse, and overuse:
Several disorders of the larynx can be causes by strain or injury to the vocal
cords through excessive talking, throat clearing, coughing, smoking, screaming,
singing, or speaking too loudly or too low. Eventually, frequent vocal abuse and
misuse can cause permanent changes in vocal function and possibly the loss of
voice. Disorders causes by abuse, misuse, or overuse include:
An inflammation or swelling of the vocal cords.
Vocal cord nodules:
Small, benign growths on the vocal cords. Nodules
are among the most common vocal disorders. Professional singers are often
affected by nodules.
Vocal cord polyps:
A condition similar to a vocal nodule, but softer and
more blister-like. Heavy smokers often experience this condition.
Vocal cord hemorrhage:
A sudden loss of voice, usually due to screaming,
shouting, or other strenuous vocal tasks. In a hemorrhage, one or more of
the blood vessels on the surface of the vocal cord rupture and the soft
tissues of the vocal cord fill with blood. It is treated with absolute voice
rest until the hemorrhage resolves.
Professional voice disorders:
Many people who use their voices for a living may experience either temporary or, on occasion,
more long-lasting problems with their voices. These include singers and public
speakers in many professions. Persistence of such symptoms should prompt a visit
to a laryngologist.
People with this condition
experience involuntary movements of one or more muscles of the larynx. This can
cause difficulty in speech, or make it sound as if the patient's voice is
breaking or is tight or strangled.
This is a disease in which
tumors grow inside the larynx or vocal cords, or the respiratory tract leading
from the nose into the lungs. The tumors, which are caused by the human papilloma virus (HPV),
may grow very quickly. This may cause breathing problems if the patient's airway is blocked.
Laryngeal papillomatosis can affect adults, children, and infants, with many cases occurring in
children, usually before age three.
Vocal cord paralysis:
This voice disorder takes place
when one or both of the vocal cords in the larynx do not open or close properly.
Vocal cords enable people to talk when air held in the lungs is released and
passes through the cords, causing them to vibrate and make sounds. In addition
to affecting speech, vocal cord paralysis can cause coughing and difficulty
swallowing, as food or liquids slip into the trachea and lungs. Although the
main symptom tends to be a breathy and weak voice, symptoms of vocal cord
paralysis can be more significant. The disorder can be caused by head trauma, neurologic conditions
such as Parkinson’s disease or multiple sclerosis, a stroke, neck injury, prior neck or chest surgery, cancer, or a viral infection.
Laryngopharyngeal reflux disease (LPRD):
This condition is also called heartburn, acid reflux disease, or gastric reflux
disease (GERD). GERD is a burning sensation in the chest that may occur after
eating, bending, stretching, exercising, and lying down. GERD occurs when the
contents of the stomach travel back up into the esophagus. This can happen when
the lower esophageal sphincter (LES) valve, which controls the passage of food
from the esophagus to the stomach, fails to close correctly. Reflux can affect
the larynx and cause symptoms such as coughing, hoarseness, inflammation, and
sore throat. In such cases it is referred to as Laryngopharyngeal Reflux
Disease. LPRD is thought to be one of the potential causes of laryngeal cancer.
Though many growths that affect the
larynx are non-cancerous, cancerous tumors can also grow in the larynx. The
inner walls of the larynx are lined with cells called squamous cells. Almost all
laryngeal cancers begin in these cells and are called squamous cell carcinomas.
If not caught early, laryngeal cancer can spread (metastasize) to nearby lymph
nodes in the neck. Smokers are at higher risk than non-smokers for cancer of the
larynx. The risk is even higher for smokers who drink alcohol. Fortunately, if
caught early, laryngeal cancer is very treatable. Constant hoarseness while
speaking is an early symptom of this cancer.
This condition is a narrowing of the airway that can cause
problems with breathing. It can be caused by infection, neck injury, or prior intubation (placement
of a breathing tube). Stenosis is much more common in some chronic diseases, such as Wegener’s Granulomatosis.
People with this condition have difficulty
and pain when swallowing. Some people with dysphagia may be unable to swallow
solid foods, liquids, or even saliva. This can lead to the patient becoming
malnourished, since he or she is unable to take in enough calories. Dysphagia
can also lead to serious infections when poor swallowing causes food to get
trapped in the lungs or outside the esophagus. Dysphagia happens when the larynx
does not close tightly during swallowing. Dysphagia is often seen in patients
who have suffered strokes.
If you notice symptoms that you think could fit any of
these conditions, consult your doctor immediately.
What are the causes of diseases of the larynx?
Conditions that affect the larynx have many causes.
These include vocal abuse or overuse, which may cause vocal cord nodules,
polyps, or laryngitis. Smoking and drinking can cause laryngeal cancer. Traumas
or neurological conditions may cause vocal cord paralysis.
How are diseases of the larynx diagnosed?
Diseases of the larynx are usually diagnosed by a
laryngologist or otolaryngologist. He or she will first perform a physical
examination. Depending on your symptoms, other tests will probably be needed.
These include X-rays, a biopsy (if cancer is suspected), or an endoscopic
examination (in which a long tube with a camera is inserted into the esophagus)
if GERD is suspected.
If your doctor suspects you have vocal cord paralysis,
he or she may order a laryngeal electromyography (LEMG). This test measures
electrical currents in the voice box muscles that are the result of nerve
inputs, and can check for nerve damage in the vocal cords.
To diagnose disorders of vocal misuse such as polyps,
cysts, or nodules, a laryngologist may examine the vocal cords by using a tool
called a rigid laryngoscope. In this test, a lighted, tube-like device is passed
through the patient's mouth to allow the doctor to view the vocal cords.
Other tests that may be done to diagnose problems with
the larynx include CT scans and MRIs.
How are diseases of the larynx treated?
Treatments for conditions that affect the larynx vary
depending on your diagnosis. Treatment for conditions causes by vocal abuse,
misuse, or overuse may be as simple as resting the voice. Voice or singing
therapy might also be recommended.
Surgery, radiation therapy, chemotherapy, or a combination of these treatments may be used
to treat laryngeal cancer. Surgery may also be required to treat nodules, polyps, or cysts.
Treatment for conditions of the larynx and vocal cords
are highly individual, depending on your condition, age, and profession. Your
doctor will take all of these into account to create a personal treatment plan.
What can be done to prevent diseases of the larynx?
Quitting smoking and cutting back on drinking alcohol can help prevent laryngeal cancer.
Taking proper care not to strain the voice through
excessive use or misuse can prevent conditions such as polyps and nodules. This
is especially important for singers or people such as teachers or lawyers, who
spend much of their day speaking. Taking time to rest your voice can help a good
deal in preventing these conditions.
It is important to note that most conditions affecting
the larynx are treatable if you seek medical attention when you first notice
your symptoms. Failing to do so may mean permanent damage to the larynx and voice.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/22/2009…#14520