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The thyroid gland's voice goes down. How does your thyroid gland work? Antiseptics for topical use

Our expert is a laryngologist surgeon, leading specialist, head of the scientific and clinical department of diseases of the larynx of the Federal State Budgetary Institution NCCO FMBA of Russia, Candidate of Medical Sciences Ibragim Nazhmudinov.

Where is the wheezing coming from?

Hoarseness can appear not only with a cold or overexertion of the voice, but also against the background of allergies, ligament injuries, intoxication of the body, paralysis and paresis of the laryngeal nerve. In children, hoarseness may occur due to congenital cyst larynx, entry of a foreign body or due to hormonal changes in the body during adolescence.

Hoarseness may have more serious causes. Modern clinical statistics shows that laryngeal oncology accounts for 20-25% of big picture cancer diseases in the world. These are not only benign tumors, such as polyps, fibromas, nodules, cysts, papillomas, but also malignant ones, such as laryngeal cancer.

Therefore, if hoarseness appears against the background of complete health or does not go away for a long time after acute laryngitis, you need to consult a specialist.

Let's go to the doctor

Often dangerous diseases larynx is mistaken for a cold, bronchitis or asthma, because the symptoms of these diseases are similar. Therefore, with persistent long-term hoarseness, patients often think that they have not recovered enough from a cold and try to undergo intensive treatment. But if hoarseness persists for more than two weeks, this is a reason to be wary.

To dispel fears, a visit to a therapist, alas, is not enough. Only an examination by an ENT specialist using special diagnostic equipment, ranging from a laryngeal speculum, which is available in any clinic, and ending with methods such as laryngoscopy with a rigid endoscope, fibrolaryngoscopy, stroboscopy, will reveal the cause of the disease.

Don't delay your visit to the doctor. The fact is that many oncological diseases the larynx at the initial stage proceeds without bright severe symptoms And pain. The person does not notice that there is a slight hoarseness in the voice, and believes that this is the result of fatigue or excessive smoking. But without serious reasons, such a picture cannot exist.

Unfortunately, doctors often see patients with stage 3-4 cancer who long time They ignored their hoarseness and sought help only when they noticed the feeling of a certain lump in the throat, and this is already a sign of an advanced disease that will require complex surgical treatment.

Take care of the bundles!

The risk group for laryngeal diseases primarily includes people in vocal professions - teachers, actors, call center employees, educators, lawyers, as well as employees employed in hazardous work, smokers.

To prevent the development of dangerous diseases, you need to follow a number of simple recommendations.

Treat your cold promptly. Undertreated acute laryngitis, which occurs against the background of colds or infectious diseases inflammatory processes, often becomes chronic and can lead to the growth of benign and sometimes malignant neoplasms.

Avoid prolonged overvoltage vocal cords, from time to time you need to give your voice a chance to rest. Therefore, if you have to talk a lot at work, try not to strain your voice at least at home.

Avoid too hot, spicy or sour food and drinking. Such food leads to irritation and sometimes burns of the laryngeal mucosa.

Use household aerosols carefully. Spray them as far away from you as possible.

Don't smoke, don't abuse alcohol.

If possible, try to avoid being in smoky rooms. When working with harmful substances use respirators.

Be careful about your health. Don't neglect going to the doctor. Even such a natural process as teenage voice breakdown, which is also accompanied by long-term hoarseness, requires observation by an ENT specialist.

Hoarseness of voice– the phenomenon is not the most pleasant. It can interfere with full communication and work, and cause serious discomfort. Therefore, you need to determine what led to the hoarseness of your voice, and what you can do to restore its sonority.

Pathological changes voices are scientifically known as dysphonia. They are provoked by inflammation of the mucous membrane of the larynx or directly the vocal cords. Hoarseness is also accompanied by symptoms such as a feeling of dryness and soreness in the throat, and a desire to cough.

If the person tries to talk, the situation may worsen. The voice becomes rough and hoarse when the ligaments thicken or deform. Hoarseness also appears when sound wave encounters obstacles on the way in the form of edema or various formations.

The most common cause of hoarseness is long-term ligament strain, flu, ARVI and sore throat. Sharp or chronic forms tracheitis and laryngitis, the risk of diphtheria cannot be excluded. Change of voice color - characteristic symptom all these pathologies. Other manifestations are the presence of a dry cough, a slight increase in temperature. Sometimes the voice may disappear completely. IN in this case treatment should be comprehensive: eliminate both the source of inflammation and the immediate symptoms.

But it happens that a person did not catch a cold or become hypothermic, did not strain his voice in singing or performing, but, nevertheless, unpleasant hoarseness manifested itself. There can be a lot of reasons for this; there are both very mild ones and those that pose a serious danger.

  • Stress and nervous tension. Happens before important exams, interviews, performances. Usually in this case, to restore your voice, you just need to drink some sedative and a glass of water.
  • Dehydration. It makes itself felt by constant thirst, a feeling of dryness in the mouth and, accordingly, a hoarse voice.
  • Chemical poisoning. Chemical reagents such as fluorine, bleach, and ammonia can lead to poisoning. This can happen both due to professional activities and due to the use of strong household chemicals at home. The consequence is swelling of the larynx. In case of poisoning, washing the nose, eyes and mouth with a soda solution and analeptic drugs helps. It will also be useful to dissolve two egg whites in a glass of milk and drink this mixture.

Also, hoarseness is sometimes a sign of certain diseases:

  • Allergy. Hoarse voice - alarming symptom, which can provoke such an unsafe condition as laryngeal stenosis and Quincke's edema. Treatment should be urgent, and resuscitation measures may be necessary. The use of antihistamines and glucocorticosteroids is also expected.
  • Impaired metabolism. Swelling of the larynx and vocal cords may be a sign hypothyroidism. In this case, hormonal agents may be indicated for treatment.
  • Burns. Burns can be caused by ethyl alcohol in alcoholic drinks, nicotine in cigarettes, as well as acetic acid. Needed in mandatory give up your not-so-good ones good habits. In the presence of scar changes, the situation is especially difficult: the voice is not always restored in such cases.
  • Reflux esophagitis. This concept refers to injury to the larynx caused by the acidic contents in the stomach. Treatment may be either surgical or conservative. In this case, the patient may be advised to follow an appropriate diet.
  • Benign formations in the larynx and on the vocal cords, for example, there are polyps. Surgery is needed to restore normal voice characteristics.
  • Laryngeal injury, which was obtained as a result of general anesthesia.
  • Nerve palsy, responsible for supplying the larynx.
  • Oncological diseases of the larynx requiring emergency surgery.

There are a lot of reasons, and if you don’t know what exactly caused hoarseness, you should consult a doctor. He will assign you necessary measures treatments that are suitable specifically for your case.

Treatment

Therapy should be aimed at fighting the cause, due to which the vocal folds were damaged. If a problem arises due to smoking or alcohol abuse, then the first thing you need to do is give it up.

If the essence of such an unpleasant change is overstrain, it is necessary for the speech to receive peace for several days. If the cause is more serious pathologies, then the help of a specialist is needed, under whose supervision the treatment will be carried out, and whose recommendations must be followed.

Along with eliminating the cause, treatment is also necessary to combat immediate symptom of hoarseness, for which, as a rule, certain medications are prescribed.

Treatment with folk remedies

To restore your voice, it is necessary that where you are there is always optimal humidity. In addition, there are many folk methods that will restore your voice. They are aimed specifically at combating the symptom, and not at eliminating the root cause, but if you need a quick result, you can use them.

Pay attention to these methods:

  • Active helps drinking warm drinks, such as mineral water, berry fruit drinks, herbal teas. It is also useful to drink some hot beer at night.
  • Opera singers know firsthand that their voices can become hoarse right before an important performance. Therefore, they have their own method of dealing with this unpleasant phenomenon. Mix two yolks and two tablespoons of sugar, beat it all, add 50 g of cognac. Before going to bed, you need to drink a teaspoon of this composition and wash it down with water. In the morning your voice should be restored.
  • Useful combination - mixture figs and milk. For 2-3 pieces of fruit you need a glass of milk. The composition must be heated, but not brought to a boil. Use several times a day.
  • You can also drink a decoction of lungwort with the addition of linden honey.

Drugs (medicines)

As symptomatic therapy the most various medications. So, some sprays are effective, which must be sprayed while inhaling deeply. These are products such as Kameton and Bioparox. Lozenges that need to be dissolved, such as Septolete, will be useful. Gomevox tablets have also proven themselves to be effective.

Drugs that are used against hoarseness are divided into several groups. Yes, they can be shown antiseptic solutions, various lozenges, inhalations and antihistamines. In particular difficult situations Doctors prescribe antibiotics or corticosteroids.

For what reasons does the voice disappear? Loss of voice (aphonia) occurs due to a violation of vocal function, which may be caused by organic and functional reasons. If during a visual examination of the oropharynx there is no inflammation and redness of the mucous membranes, such diseases are called functional.

Organic aphonia is a consequence of the development of somatic pathologies that cause inflammation of the components of the voice-forming apparatus. The causes of voice disorders are so varied that only a specialist can accurately determine the etiology of aphonia after examining the patient.

Voice dysfunction is often associated with constant stress, hormonal imbalance, exacerbation chronic diseases, the appearance of tumors in the larynx or banal overstrain of the vocal cords.

About anatomy

  • larynx - sound generator;
  • paranasal sinuses, bronchi, nasopharynx and trachea are sound resonators;
  • teeth, lower jaw, muscles of the pharynx, soft palate and tongue - articulatory department.

Any disturbances in the structure of the above-mentioned systems negatively affect the voice and its sonority. Inflammation and disruption of the innervation of the vocal apparatus is a key cause of the development of functional or organic aphonia. It is worth noting that the causes of vocal dysfunction may lie in the development of diseases of organs that are not directly related to the vocal apparatus. Some diseases of the cardiovascular, endocrine and nervous systems lead to a change in voice timbre, the appearance of hoarseness, hoarseness, etc.

Respiratory diseases

If the throat does not hurt, this is not yet proof of the complete absence of inflammation in the throat. respiratory tract.

Aphonia can occur against the background of exacerbation of chronic diseases that do not cause discomfort in the throat, however, they provoke inflammation of the larynx and vocal cords.

  • chronic tracheitis - bacterial damage to the tracheal mucosa, accompanied by swelling of the pharynx, bronchi and larynx;
  • chronic laryngitis is a sluggish inflammation of the larynx, which leads to swelling of the vocal cords, as a result of which the voice may become hoarse;
  • chronic pharyngitis - septic inflammation of the lymphoid tissues of the pharynx, which may involve tonsils, trachea, vocal folds, etc.

A lost voice can be restored only if pathogenic agents in the larynx are completely destroyed and swelling in the vocal cords is eliminated. Hypothermia, hypovitaminosis, tobacco smoking, irrational intake of hormonal and antimicrobial agents etc.

Neoplasms in the throat

For what reason did your voice disappear, but your throat doesn’t hurt? The appearance of benign and malignant neoplasms in the respiratory tract can lead to the development of aphonia. As a rule, on initial stages tumor growth, the patient does not complain of pain or discomfort in the throat.

As the disease progresses, patients may experience complaints of a feeling of squeezing in the throat, hoarseness, difficulty breathing, etc. Such symptoms may be a consequence of the development of pathologies such as:

  • laryngeal papilloma - benign tumors that form from cells squamous epithelium when the body is affected by the papilloma virus; in the process of tumor growth, the voice gradually “sits down” and may completely disappear;
  • laryngeal pachyderma - white-gray plaques that form on the vocal folds, which interfere with normal breathing and lead to impaired voice production;
  • fibroma is a tumor of dense consistency that forms mainly on the edge of the vocal fold;
  • “singing” nodules are symmetrical neoplasms on the vocal folds, formed from connective tissue; arise mainly in people of “vocal” professions;
  • polyps - benign neoplasms, which often develop from “singing” nodules.

Some benign neoplasms have a tendency to become malignant, so pathologies need to be treated in a timely manner.

It is possible to accurately determine the causes of aphonia and the nature of neoplasms only after submitting biomaterials for histological analysis and biopsy. Tumors can grow to large sizes, which can lead not only to voice impairment, but also to hypoxia.

Laryngeal paralysis

Why does my voice disappear? When the innervation of the laryngeal muscles is impaired, a disease such as paresis of the vocal cords or larynx develops. The causes of myogenic paralysis can vary. As a rule, the development of pathology is facilitated by:

Based on their origin, there are two types of laryngeal paralysis:

  • myopathic - a violation of the innervation of the muscles of the larynx;
  • neurogenic - disruption of the conduction of nerve impulses from the larynx to the corresponding parts of the brain.

Untimely treatment of laryngeal paresis leads to ankylosis, in which persistent impairment of vocal function is observed.

The occurrence of “wheezing” breathing is a good reason to seek help from a doctor. The symptom indicates a narrowing of the glottis, which over time can close completely and provoke acute asphyxia.

Endocrine disorders

The voice may become hoarse due to the development of endocrine diseases. Not long ago, experts established a connection between vocal dysfunction and thyroid pathologies. The development of diseases is indicated by rapid fatigue, narrowing of the sound range, hoarseness of voice and general malaise.

Damage to the thymus (thyroid) gland leads to an increase in its size and compression of the larynx. Subsequent circulatory disorders entail tissue swelling and, accordingly, the development of aphonia. Endocrine pathologies that lead to disruption of the voice-forming apparatus include:

  • hypothyroidism - deficiency of thymus hormones, which leads to gelatinous swelling of the vocal folds;
  • diffuse goiter - pathological increase thyroid gland, leading to a decrease in the timbre of the voice or a feeling of compression of the larynx;
  • hyperthyroidism is an overactivity of the thyroid gland, which leads to an increase in the concentration of hormones in the body and the occurrence of swelling in the respiratory tract.

The causes of hoarseness may lie in dysfunction of the adrenal cortex. Failures in the functioning of the adrenal glands lead to rapid depletion of the voice, which worsens in evening time. With hyperfunction of the adrenal glands, the throat may not hurt, but the development of pathology will be indicated by an obvious narrowing of the vocal range.

Aphonia may be a consequence of development hormonal disorders, which are useless to treat with rinses, inhalations and symptomatic medications.

Other reasons

Why can the voice disappear if there are no symptoms of inflammation in the throat? There are many non-infectious causes dysfunctions of voice formation. The causes of aphonia lie in overstrain of the vocal cords, allergic swelling of the mucous membranes of the respiratory system, congenital pathologies of the vocal apparatus and injuries.

Spastic aphonia is a common phenomenon that is of neurogenic origin. If pathology develops, the vocal cords contract involuntarily, which causes “squeezing” and a decrease in voice timbre. The most likely causes of the problem include:

  • smoking;
  • constant stress;
  • eating spicy food;
  • mechanical injuries;
  • damage to the laryngeal nerves;
  • high speech loads;
  • mental disorders;
  • neurological diseases.

A short-term lack of voice is not a good reason to seek help from a doctor. But if the hoarse voice does not recover within 3-4 days and the symptoms of the disease only worsen, you need to make an appointment with a phoniatrist.

Only after examining the patient will the doctor be able to determine the cause of the pathology and prescribe adequate treatment.

The thyroid gland is allocated vital role in the body, it produces hormones that are responsible for correct work many organs and systems. Therefore, if its function is impaired, the entire body suffers and this entails serious health problems.

Quite often, problems with the thyroid gland are reflected unpleasant sensations in the front of the neck, constriction of the throat, feeling of suffocation. In our article we will try to talk about what to do if the thyroid gland is pressing on the throat, why this condition occurs, its main methods of treatment.

Causes of thyroid pressure on the throat

Since the thyroid gland is located in the front of the neck, the slightest increase in it causes pressure on the walls of the throat, a feeling of discomfort arises, the person feels that the throat is being pressed, and it becomes difficult to breathe. The main reasons that lead to this condition are:

  • Inflammation of the thyroid gland (thyroiditis). There are several main types of the disease: Hashimoto's thyroiditis, purulent, non-purulent and Riedel's thyroiditis. Purulent often occurs against the background of infection. It enters the body, affects the gland, thereby causing its enlargement, pain in the neck, fever, etc. Non-purulent inflammation is associated with various injuries and damage to the thyroid gland. Hashimo's thyroiditis is an autoimmune disease, while Riedel's thyroiditis is classified as a fibrous disease, the cause of which is still not fully understood.
  • Thyroid oncology. This is a serious pathology that requires timely diagnosis and proper treatment. In this case, the patient’s health condition deteriorates significantly, and strong pain in the area of ​​the gland, over time the organ enlarges, the patient finds it difficult to breathe, and strong pressure arises in the throat, making it difficult to swallow.
  • Hyperthyroidism ( increased production hormones). In addition to disruption gastrointestinal tract, of cardio-vascular system, nervous disorders, this pathology characterized by an increase in the size of the thyroid gland, swelling in the neck. In this regard, patients complain that the throat is tight, it is difficult to breathe, shortness of breath occurs, and the voice changes.
  • Benign formations. Benign tumors can also cause the above symptoms and often lead to a condition where there is a feeling of pressure in the throat.

What to do if the thyroid gland compresses the throat

Of course, all patients are interested in the question of what to do when the thyroid gland presses on the throat. The only correct decision in this case is to immediately contact a specialist.

As a rule, in this situation, the doctor conducts a thorough diagnosis and finds out the cause of this condition. The initial examination is visual inspection patient and palpation of the thyroid gland, the doctor may also prescribe additional diagnostics, most often this is an ultrasound examination of the organ, hormone tests, and, if necessary, a biopsy.

When the above-described condition occurred against the background of increased hormonal levels, the basis of treatment is hormone therapy, in which the patient is prescribed synthetic hormones.

To relieve the symptoms of thyroiditis, many patients are prescribed replacement therapy, which includes the use of thyroid hormones. In case of purulent form, antibiotics must be taken; in some cases, corticosteroids are indicated. This therapy may also include symptomatic remedies, taking vitamins, immunostimulating drugs, and alternative methods of treatment.

For malignant and some benign formations, the main therapeutic method called surgical intervention. Through surgery, a tumor or an entire organ is removed from patients. In case of small benign formations, not requiring surgical treatment, patients are recommended a special diet and regular examination by a doctor.

It should be remembered that the thyroid gland needs special attention, at the slightest suspicion of irregularities in its work, especially when there is a feeling that there is pressure in the neck, you should immediately undergo examination by an endocrinologist.

Diet for thyroid diseases: healthy foods

Most common diseases

The thyroid gland is a gland internal secretion, which is responsible for metabolic processes, growth and development of tissues and organs, as well as others essential functions body. Job of this body directly related to hormones such as triiodothyronine, thyroxine and calcitonin. Insufficient and excessive activity of the thyroid gland in equally are dangerous and cause serious complications.

Among the main causes of thyroid diseases is an insufficient amount of iodine in food and water. In addition to iodine deficiency, thyroid pathologies can lead to chronic stress, genetic failures ( hereditary factor), a number of chronic and infectious diseases, taking some medicines, unfavorable environmental conditions, including radiation.

These reasons lead to the fact that the function of the thyroid gland decreases (hypothyroidism occurs) or increases (hyperthyroidism), or changes occur in the structure of the organ (goiter, nodules in the thyroid gland, hyperplasia are formed). All these diseases are characterized by the following symptoms:

  • constant physical weakness;
  • fast fatiguability;
  • irritability.

Specific manifestations are observed depending on whether the function of the thyroid gland is increased or decreased. For example, if the metabolism accelerates with hyperthyroidism, then the patient may notice:

  • sudden weight loss;
  • rapid pulse;
  • tremor of the limbs;
  • increased sweating;
  • insomnia.

Thyrotoxicosis occurs due to a sharp increase in the activity of the thyroid gland, intoxication of the body occurs due to increased production of hormones. A characteristic manifestation of this disease is the so-called bulging eyes, as well as the development of goiter and photophobia.

Hypothyroidism leads to severe weight gain, tissue swelling, increased blood pressure, dry skin and hair, and bradycardia.

A thyroid goiter may have a nodular structure ( nodular goiter) or formed due to excessive growth of organ tissue - then it is called diffuse. The presence of both nodes and overgrown tissues indicates mixed type goiter Because similar education squeezes neighboring organs and tissue, this disease can be suspected based on the following signs:

  • hoarse voice;
  • sensation of a foreign body, a lump in the throat, pressure in the neck;
  • dyspnea;
  • difficulty swallowing.

How larger size goiter, the more pronounced the symptoms will be. An advanced disease can cause pain, which indicates the development of inflammatory processes and possible internal hemorrhage. Inflammation is indicated by increased The lymph nodes on the neck.

The growth of cervical lymph nodes may indicate the presence of a malignant thyroid tumor with metastases. Autoimmune diseases The thyroid gland causes the formation of antibodies and leukocytes, which, acting together, stimulate its function or disrupt the integrity of tissues. Among such diseases, the most common (about 1% of thyroid diseases) are autoimmune thyroiditis and diffuse toxic goiter.

With autoimmune thyroiditis, patients experience the following symptoms:

  • bradycardia appears;
  • the timbre of the voice changes, it becomes low and hoarse;
  • speech becomes slurred and clarity disappears;
  • facial features become coarser;
  • shortness of breath appears even after little physical activity;
  • memory deteriorates;
  • weight increases.

The problem is that in many cases clear signs no disease is observed. Discover serious illnesses thyroid gland, including a malignant tumor, can be ultrasound examination or special blood tests for hormones.

General symptoms of thyroid diseases

It is worth contacting an endocrinologist for examination if the following symptoms occur:

  • severe weight loss or weight gain for no apparent reason;
  • increased irritability;
  • fast fatiguability;
  • skin and hair become dry, hair becomes brittle and falls out;
  • muscle pain;
  • dyspnea;
  • sensation of a foreign object in the throat (lump);
  • changes in hormonal levels;
  • passivity or, conversely, hyperactivity in the child;
  • failures menstrual cycle among women.

The above symptoms indicate possible availability problems with thyroid gland, therefore, it is necessary to undergo examination and begin treatment as quickly as possible to avoid serious complications.

Features of diseases in men, women and children

The same thyroid diseases in men and women, as well as in at different ages appear similar symptoms, but there are also some distinctive features. Thyroid pathologies are more common in women than in men, and “ female version» diseases are characterized by more severe symptoms and the most serious consequences for health.

Problems at work endocrine system, including the thyroid gland, are often associated with hormonal imbalances: adolescence, pregnancy, menopause. During these periods, girls and women need to be very careful about their health and if there is the slightest suspicion of endocrine disease consult a doctor for advice.

During pregnancy, thyroid disease in the absence of adequate therapy threaten to arise congenital pathologies The child has. There are frequent cases of infertility in women suffering from thyroid diseases. Pronounced premenstrual syndrome and an irregular monthly cycle are clear signs of hormonal imbalances, which may be caused by thyroid disease.

In men, problems with the thyroid gland are less common and are manifested by decreased libido and erectile dysfunction.

IN childhood You can suspect a dysfunction of the thyroid gland if the child suffers from excessive thinness and hyperactivity or, conversely, passivity and obesity with proper nutrition.

Diet: menu for the week

Therapy for thyroid diseases requires mandatory intake hormonal drugs in the dosage prescribed by the doctor and a special diet. An important condition proper nutrition is complete failure from smoking and alcohol, sweet carbonated drinks, pickles, smoked, canned food, coffee, sweets and spicy seasonings. You should limit the consumption of bread, pastries, sausages, strong tea, and white rice.

The diet for hypo- and hyperfunction of the thyroid gland is different. If in the first case it is necessary to focus on reducing the calorie content of food to combat obesity, then in the second, on the contrary, it is necessary to increase the patient’s weight and strengthen his health.

Diet for hypothyroidism

Therapeutic meals are served five times a day, the daily calorie content of food should not exceed 2100 kcal. Particular preference should be given to low-fat fermented milk products, vegetables, fruits and cereals.

For breakfast you can eat buckwheat with meat (boiled or steamed), drink weak tea or herbal decoction. Suitable for second breakfast skim cheese and fruit or berry compote without sugar. You can eat it for lunch vegetable soup, meat or fish with a vegetable side dish and drink compote. Meatballs made from fish, meat or poultry and unsweetened tea are suitable for an afternoon snack. It is recommended to cook light for dinner vegetable salad, egg white omelette and compote. If you feel hungry before going to bed, you can drink jelly.

Example of a menu for a week for hypothyroidism (dishes to choose from):

Diet for hyperthyroidism and thyrotoxicosis

Nutrition for these diseases should help reduce the activity of the thyroid gland and reduce the production of hormones. To do this, you should large quantities eat foods rich in calcium and phosphorus (cheeses, beans, sardines, parsley, dill, cabbage, basil, etc.), and avoid those that contain iodine or stimulate the central nervous system. Food should preferably be plant-based; you need to take fiber in the form of dietary supplements or with food (cereals, legumes, pumpkin, apples, tomatoes, potatoes, avocados).

For breakfast, a vegetable salad with apples, seasoned with sour cream, a piece of cheese, an omelette, oatmeal, and tea are perfect. You can have a snack with toast and cheese, have a drink tomato juice. For lunch you can eat borscht, for the main course - boiled chicken with brown rice, wash down with unsweetened compote. Biscuits and rosehip decoction are good for snacking. You can cook for dinner vegetable puree with meatballs, casserole and tea. You are allowed to drink kefir at night.

Healthy foods

Help to replenish iodine deficiency in hypothyroidism seaweed, fish (especially red), cod liver and seafood, as well as healthy foods containing large amounts of protein: lean meat, eggs, legumes. IN sufficient quantity It is necessary to eat fresh fruits and vegetables, cereals. It's important to remember that excessive use water can lead to the formation of edema, which already occurs with a slow metabolism. Clean water should be drunk in quantities of no more than 1.5 liters per day, but not at night.

With hyperthyroidism, you need to pay more attention to foods rich in vitamins, phosphorus and calcium, and additionally take vitamin and mineral complexes.

– various disorders vocal functions due to pathological condition vocal organs. Voice disorders are manifested by insufficient strength, pitch, distortion of timbre, vocal fatigue, soreness, pain, and a “lump” in the throat. In case of voice disorders, the patient should be consulted by an otolaryngologist and phoniatrist with a study of voice function, and also examined by a speech therapist. Overcoming voice disorders includes medical measures (medication or surgery, FTL, psychotherapy) and speech therapy (voice mode, breathing and articulation exercises, phonopedic exercises, etc.).

ICD-10

R49

General information

Voice disorders are a group of voice disorders characterized by partial or complete absence phonation. Voice disorders are more common in people of vocal professions (teachers, lecturers, actors, singers, etc.) who experience heavy speech load, in adolescents in puberty, children and adults with various speech pathologies (rhinolalia, dysarthria, alalia, stuttering, aphasia) . Thus, about 60% of teachers suffer from voice disorders, 6-24% of adolescents during the mutation period and 41% of children with speech problems. In turn, voice disorders impede the full development of speech and communication, worsen neuropsychic state, impose restrictions on the choice of profession.

Voice disorders are a medical and social problem, therefore they are studied by medical and pedagogical disciplines - otolaryngology (and its highly specialized section - phoniatrics), neurology, psychiatry, speech therapy (and its highly specialized area - phonopedia).

Classification of voice disorders

According to the degree of phonation disorder, dysphonia (partial impairment of the strength, pitch and timbre of the voice) and aphonia (absence of voice) are distinguished. With dysphonia, the voice becomes dull, hoarse, hoarse, unmodulated, broken, quickly exhausted, and sometimes nasalized. Aphonia is characterized by a complete absence of voice sound and the ability to speak only in a whisper.

Based on the causes and mechanisms of phonation disorders, they are distinguished:

  • central (psychogenic aphonia or hysterical mutism)
  • peripheral (phonasthenia, hypotonic and hypertonic dysphonia or aphonia, pathological mutation)
  • central (dysphonia and aphonia with dysarthria and anarthria)
  • peripheral (dysphonia and aphonia in diseases of the larynx; rhinophonia).

Causes

Central organic voice disorders are associated with paralysis and paresis of the vocal cords caused by damage to the brain stem or cortex, which conducts nerve pathways. Central organic voice disorders occur in children with cerebral palsy.

Causes of peripheral organic disorders different voices speak inflammatory diseases or anatomical changes in the vocal apparatus. These include chronic laryngitis, burns and injuries of the larynx, peripheral paresis and paralysis (if affected recurrent nerve), “singing nodules”, tumors (papillomatosis) of the larynx, postoperative scars and laryngeal stenosis, a condition following laryngectomy or laryngectomy.

With functional voice disorders, the activity of the vocal apparatus is disrupted in the absence of organic damage. Central functional voice disorders (psychogenic aphonia) are a consequence of an acute psychotraumatic situation. It occurs more often in women prone to neurotic reactions.

Peripheral functional voice disorders such as phonasthenia can be caused by excessive vocal stress, non-compliance with the voice regime during respiratory diseases. Pathological mutation of the voice in adolescents may be due to endocrine disorders, early smoking, overload of the vocal apparatus during this period. Hypotonic dysphonia and aphonia most often result from bilateral myopathic paresis (paresis of the internal muscles of the larynx) caused by ARVI, diphtheria, influenza, and severe voice strain. The development of hypertonic (spastic) dysphonia and aphonia is usually associated with excessive forcing of the voice.

Symptoms of organic voice disorders

Voice disturbances in chronic laryngitis are caused by damage to the neuromuscular apparatus of the larynx and non-closure of the vocal folds. Voice defect is expressed by loss of normal sound, severe fatigue, and sometimes the inability to perform vocal tasks. Characterized by unpleasant subjective sensations in the throat - scratching, soreness, rawness, sensation of a “lump”, pain, pressure.

In the case of peripheral paralysis and paresis of the larynx, the voice may be completely absent or have a hoarse sound. Voice impairment is accompanied by severe speech fatigue, reflex cough, choking, and respiratory distress. Discoordination of phonation and breathing significantly aggravates the defect.

Voice disorders associated with benign and malignant tumors of the larynx develop gradually as the tumors grow. After any, even gentle, surgical intervention on the larynx, transient voice disturbances occur. When the larynx is removed, a person completely loses his voice; in this case, the respiratory function is sharply impaired, since the trachea and pharynx are separated.

With central paresis and paralysis of the larynx, observed with dysarthria and anarthria, the voice becomes weak, quiet, intermittent, dull, monotonous, often with a nasal tint.

Organic voice disorders in a child early age, are accompanied by a lag in speech development, delayed vocabulary accumulation and development of grammatical structures, impaired sound pronunciation, communication difficulties and limitations social contacts. Voice disorders that develop in adulthood may lead to professional unsuitability.

Symptoms of functional voice disorders

Being peripheral functional impairment voice, phonasthenia is an occupational “disease” of persons in vocal professions. Manifestations of phonasthenia include the inability to arbitrarily regulate the sound of the voice (strengthen or weaken), interruptions (misfires) and rapid fatigue of the voice, hoarseness. IN acute period With phonasthenia, the voice may disappear completely. In most cases, phonasthenia does not require treatment; The voice recovers on its own after a period of rest.

With hypotonic dysphonia, due to paresis of the internal muscles of the larynx, non-closure of the vocal folds develops, which is manifested by hoarseness, vocal fatigue, pain in the muscles of the neck and back of the head; in severe cases, only whispered speech is possible. With hypertonic dysphonia, caused by tonic spasm of the laryngeal muscles, the voice is distorted, becomes dull, rough; in aphonia – does not occur at all.

A pathological mutation can be expressed in the preservation of a high-pitched voice after puberty, voice instability (alternating low and high tones), dysphonic sound, etc.

Functional voice disorder of a central nature (hysterical mutism, psychogenic aphonia) is characterized by a complete simultaneous loss of voice, the inability to whisper speech, but at the same time preserved sonorous laughter and cough. Important differential feature is the variability of the form of non-closure of the vocal folds. The course of psychogenic voice disorder is long-term, and repeated relapses are possible after voice restoration.

Diagnostics

Determination of the causes of voice disorders is carried out by an otolaryngologist, phoniatrist, and neurologist; study of the basic characteristics of the voice - by a speech therapist. To identify anatomical or inflammatory changes laryngoscopy is performed on the vocal apparatus; to assess the function of the vocal folds - stroboscopy. In the diagnosis of tumor lesions, radiography and MSCT of the larynx are indispensable. To obtain information about the function of the muscles of the larynx, electromyography is performed. With the help of medications, inhalation), according to indications - surgical treatment of ENT pathology (removal of excess tissue of the vocal folds, resection of the larynx, laryngectomy, etc.).

Speech therapy work to restore voice disorders should begin as early as possible in order to prevent the fixation of pathological voice delivery and achieve best results, prevent the development of neurotic reactions to the defect. Main directions correctional work include psychotherapy, breathing correction, development of coordination of phonation and articulation, automation of achieved skills and the introduction of voice into free speech communication. In speech therapy classes for the correction of dysphonia, breathing and articulation gymnastics and phonopedic exercises are used. In patients after extirpation of the larynx, work is carried out on the formation of the esophageal voice.

Prognosis and prevention

The effectiveness of correction of voice disorders largely depends on their cause, timing of treatment and speech therapy sessions. For rough anatomical changes voice apparatus and central paralysis Usually only some degree of improvement can be achieved. Functional voice disorders, as a rule, are completely eliminated, however, if the speech therapist’s recommendations are not followed, relapses are possible. Important The success of correcting voice disorders depends on the patient’s organization and perseverance.

In order to prevent voice disorders, it is necessary to develop correct voice habits (not to force the voice), prevention colds, quitting smoking and alcohol, eating excessively chilled and hot food. Persons in voice-speech professions must have the skills diaphragmatic breathing and correct vocal delivery. It is unacceptable to carry any cold, even the smallest one, on your feet; During the period of illness, a gentle vocal regime should be observed.