Dear Readers,

L.M. is a 28-year-old male teacher from St. Catherine who sings with his church choir and also does a little solo singing at weddings and other events. Recently, he has been hoarse and the condition has worsened. The hoarseness makes it difficult for him to sing and despite various treatments given for sinus congestion by his general practitioner, the hoarseness is persisting.

L.M., as a teacher, is probably being exposed daily to chalk dust. Chalk dust allergy is one fairly common cause of persistent colds and hoarseness in persons who frequent the schoolroom. Despite being treated for allergies and sinus congestion, the hoarseness may persist as L.M. remains daily in the environment which may well be triggering the condition. L.M. should use only special chalk which does not generate much chalk dust. Also, he should have the blackboard cleaned several times daily with a damp cloth. Alternatively, he will need to use a 'white' board with approved markers to avoid chalk altogether. If chalk dust allergy is the root of his problems, he may even need to consider a change of occupation.

L.M. also sings and another condition which causes hoarseness in vocalists or individuals who speak a lot (e.g. teacher) is vocal cord nodules which are non-cancerous growths of tissue occurring on the vocal cords. Persistent hoarseness without pain is the primary symptom. Sometimes vocal cord modules disappear if the voices is rested for several weeks to months, but if this doesn't work then the nodules may have to be excused surgically. More rarely, sudden onset of hoarseness which persists can indicate a vocal cord paralysis which can be due to sinister causes inclusive of cancer.

In many persons, thick post-nasal drainage on to the voice box (vocal cords and larynx), occurring secondary to allergies and often aggravated by not drinking enough fluids, often causes some hoarseness. Smokers also often are hoarse and this can be a worrisome early-warning sign of cancer.

In essence, common disorders occur regularly and L.M.'s hoarseness is likely to be due to either chalk dust allergy, a chronic post-nasal drip or vocal cord nodules, conditions which are quite treatable. However, a proper diagnosis should be made by an ear nose and throat surgeon who would examine the throat and vocal cords by direct visualisation and even perform tissue biopsy. After such an examination, the treatment can be tailored to the disorder and is more likely to be successful.

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Kingston 8