5.4 Diseases of the vocal cords
- Vocal haemorrhage
- Vocal nodules
Phonasthenia is a weakened closure of vocal folds that can occur when a voice suffers from excessive stress due to a fatigue of the nervous system. The doctor will not see the changes in the condition of the nasopharynx mucosa, but the singer will have complaints about scratchiness, hoarseness, bad sounding forte and inability to sing piano. This is a functional disorder that can be eliminated with a short rest, a good sleep and proper food. Phoniatrists deal with such diseases. Often happening phonasthenia can turn into a sustainable dysphonia. The first reason of this is an incorrect singing, causing rapidly developing and recurring cords fatigue. Another reason of dysphonia is singing in a diseased state (with laryngitis or residual problems after suffering from influenza) when the infection penetrates deep into the muscles that the vocal cords contract. The voice gets a strong overtone that comes even after a short singing, intonation becomes impure, the voice ceases to sustain the tessitura, then the neck muscles suffer from the fatigue and it can be felt in the area of cords. Treatment of a chronic dysphonia can last several months. First medicine is a total silence. Women can develop a dysphonia and even a complete loss of voice (aphonia) can occur due to high stress.
Vocal haemorrhage. At the time of a big voice pressure (when shouting, forcing, with a improperly taken high note) it can come to a rupture of blood vessels in the folds, to a haemorrhage. Suddenly the voice gets hoarse. Inspection reveals that the cord is filled with blood. In this case, an absolute silence is required. Women, singing in the days of menstrual cycle, can also develop a haemorrhage. The walls of blood vessels in these days become tiny, the vocal folds (cords) and the entire mucosa swell and turn pink, covered with lumps of mucus. Therefore, singing in menstrual days should be prohibited, even in the case when singer insists that the voice sounds good. Some voices can really sound good on these days, others not, becoming completely unmanageable. However, in the concert life of the singers it comes to critical situations, when a performance cannot be cancelled: on tour, in the ensemble, when one person performs the party and he cannot be replaced. Still, it should be done only in cases of real need.
Vocal nodules. Frequent bleedings may lead to the formation of nodules on the vocal cords, as well as an improper use of the voice and incorrect singing skills (such as singing with cords overstraining and forcing). Nodules do no let the vocal cords contract. The singing voice may disappear altogether. If the nodule doesn't dissolve after a long silence, then it is removed by operating.