Dear Readers,

S.E. is a 40-year-old school teacher, who lives in Barbican, St Andrew. She says she has suffered from sinusitis for years and was told it was related to her exposure to chalk dust.

she has been hoarse for several months. She visited an ear, nose and throat (ENT) specialist, who examined her and told her that she had nodules on her voice box, which probably needed to be removed surgically. S.E. has asked lifeline if the hoarseness and nodules could have been caused by her chalk allergy and should she consider giving up teaching. S.E. is frightened that she might have cancer and the doctor is hiding the condition from her.

Serious thing

It is a serious thing these days to give up one's profession. It may be better if S.E requested a white board at school and discontinue using chalk altogether. The voice box consists of bonds of fibrous tissues, known as vocal cords, suspended across the larynx. The larynx is a structure formed from cartilage and muscle and forms the opening at the throat. Speech occurs when air is forced over the vocal cords. Vocal cord nodules refer to non-conscious growths occurring on the vocal cords.

They are fairly the cause of hoarseness in singers, teachers or anyone who spends time speaking loudly, or otherwise prolonging tension on the vocal cords.

Extended use of voice

Vocal cord nodules form due to extended use of the voice whether in public speaking, shouting, or talking loudly for too long, which teachers often do. The person with this problem usually complains of persistent hoarseness, which is not necessarily associated with any other symptom.

The consultant ENT surgeon may take a sample of the nodal swelling and test it for laryngeal cancer, which is another cause of persistent hoarseness. However, this is fairly routinely done and does not at all indicate that any malignancy (cancer) is suspected.

Allergies can also cause hoarseness due to the post-nasal dripping of secretions on to the pharynx and larynx, resulting in inflammatory swelling of the tissues. Hoarseness due to allergies will respond to treatment with antihistamines, antibiotics and steroidal nasal sprays and drops. Vocal cord nodules will remain unresponsive to this treatment. Treatment of vocal cord nodules consists initially of resting the voice and the vocal cords. Not speaking and singing. Sometimes the vocal cord nodules disappear after a few months of resting the voice box. If rest doesn't work then surgery may be advised to remove the nodules.

Do not smoke

If you have this problem with chronic hoarseness,do not smoke and avoid smokers in general. Smoking is harmful to the larynx and can injure the voice box. Avoid shouting and don't compete with people around you while singing at church. Cheering at football matches, or at various other athletic events, can also result in straining the voice and promoting the development of vocal cord nodules.

If you do strain your voice, rest it for days afterwards, allowing the vocal cords to recover. Vitamins A, C and E are good nutritional supplements to aid in healing mucus membrane such as those in the throat. They stimulate the immune system and have anti-inflammatory action. They can be taken daily.

Write to:

Lifeline

PO Box 1731

Kingston 8

AJM