Misleading FoxNews Report: Laryngitis for 30 Years

On Dec 23, 2011, Fox News reported on a woman who supposedly had laryngitis for 30 years.

The story reported that the woman had a viral URI in 1982 which resulted in laryngitis and a paralyzed vocal cord.

What people should be aware of is that a paralyzed vocal cord is NOT laryngitis. Laryngitis is an infection of the larynx or voicebox. Stating that a paralyzed vocal cord is akin to laryngitis is like claiming a person who has a paralyzed arm/leg from a stroke has an arm/leg infection.

Now it is true that a viral laryngitis can cause a paralyzed vocal cord, but they should not be considered synonymous.

Patients with a paralyzed vocal cord have a very breathy sounding weak voice and a weak cough. They may also suffer from aspiration where liquids/foods go down the wrong way more easily than normal.

Typically, the first way to treat a paralyzed vocal cord is voice therapy. If voice therapy does not make much improvement, surgical intervention can be considered.

Typically, a vocal cord injection is performed if the paralysis onset was within one year. After one year, an implant can be placed as the Fox News report mentioned.

Read more about paralyzed vocal cords as well as watch a video here.

Source:
Woman Gets Voice Back After Suffering From Laryngitis for 30 Years. FoxNews 12/23/11

Miley Cyrus "I Cut My Uvula"! ...NOT!

I was recently made aware of this video Miley Cyrus made in January 2009 when she reported that she cut her uvula (according to a nurse) after swallowing a slippery piece of chicken causing her voice to sound quite hoarse. Watch the video here:



However, based on how her voice sounds, I seriously doubt that her hoarseness is due to a cut uvula. When the uvula gets cut, or swollen, or gets injured one way or another, it would cause her voice to sound muffled... NOT raspy like her voice sounds. Though it is possible that her uvula may have been injured, it certainly is not the cause of her poor vocal quality.

Rather, I suspect that her voice sounds bad the way it does due to a vocal cord injury. Often, when people swallow a piece of food (like a chicken) that either gets stuck or goes the wrong way, the person automatically coughs severely in order to expel it.

If the cough is severe enough, it'll cause traumatic injury to the vocal cord resulting in a hoarse voice. The injury itself may not be that bad (usually a mild vocal cord submucosal hemorrhage), but the voice does sound bad. Here are two mild examples of laryngitis due to blood accumulation here and here. A more severe example of traumatic laryngitis can be found here.

In this situation, if the person persists and tries (forces) to talk and sound normal in a setting where the vocal cord is injured, compensatory behavior sets in whereby the vocal quality will fluctuate and go in and out as Miley's voice does in the video (listen to an audio of another patient with this problem here). This condition is called "compensatory muscle tension dysphonia," and in her case, secondary to acute traumatic laryngitis.

This diagnosis can be confirmed on fiberoptic laryngoscopy. Treatment is high dose steroids that will bring the swelling down as well as strict voice rest for a few days (depending on severity of the injury). Resolution of her voice would be expected within 1 week with this treatment. Voice therapy may be required, though usually not.

Read more about traumatic laryngitis here.

Read more about muscle tension dysphonia here.

Voice Problems Trouble Teachers

A hoarse voice is an endemic problem in professions who use their voices a lot including preachers, journalists, lawyers, and especially teachers. In the general population, 1 in 4 report a voice problem at some point in their life. Among teachers, 47 percent report some degree of voice abnormality on any given day; 20 percent of teachers report missing work due to voice problems, and 1-in-10 teachers has been forced to leave the profession by voice woes.

Even in Fauquier County, every year there are a few teachers I place on short-term disability due to the severity of their voice disorder.

Read a news article on this subject here.

Reference:
Voice Problems of Classroom Teachers: Incidence, Symptoms, and Associated Factors http://www.drwag.com/939.html (Presented at American Speech-Language-Hearing Association Annual convention, Philadelphia, 2004)

Prevalence of voice disorders in teachers and the general population. J Speech Lang Hear Res. 2004 Apr;47(2):281-93.