Sunday, June 20, 2010

聲沙

聲帶 (vocal cords) 位於呼吸道上端,左右各一,肺部呼出空氣流經聲帶令聲帶快速震動,產生聲音,再經咽、喉、鼻共鳴放大。當聲帶受損發炎腫脹,不能如常地開合及震動,便會造成聲沙 (hoarseness)。常見令聲帶腫脹的原因包括傷風感冒、發音時過度用力、胃酸倒流及喉嚨過敏。聲沙應減少說話,讓聲帶得以休息復原,若聲沙時仍持續發聲,可勞損聲帶,造成聲帶出血、結繭(長出小結)(cyst)、長息肉 (polyp)、結疤 (granuloma) 或產生聲帶溝,這時便需要接受治療。

一般來說,如果聲沙病情輕微,可透過言語治療 (speech therapy) 矯正發聲方法,讓聲帶休息逐漸康復,病情嚴重則需要施手術。完成治療後仍需接受言語治療、預防復發,並要培養保護聲帶的習慣,包括用適當的音量、音調和速度說話或歌唱、避免叫喊或高談過久、戒煙、戒酒、多喝水保持聲帶滋潤等。值得一提的是,聲沙也是喉癌的早期徵兆,倘若聲沙持續達四星期或以上,便要多加留意檢查。

Hoarseness is one of the most common complaints referred for ENT evaluation. It is often a result of abnormal vibration of the vocal cords. In order to produce a normal voice, both vocal cords need to come together and vibrate in synchrony. Diagnosis is by direct visualization of the vocal cords via laryngoscopic examination in the office. Processes that may impede normal vibratory function of the vocal cords include infection (eg. laryngitis), inflammation from vocal abuse or laryngeal reflux, benign vocal cord masses (eg. vocal nodules/ cysts/ polyps), and malignant laryngeal tumors. Speech therapy is often necessary to correct abnormal use of vocal cord muscles. Vocal hygiene such as hydration, smoking and alcohol cessation, and voice rest should be followed. Surgery is reserved for large lesions or persistent hoarseness refractory to speech therapy. If there are any concerns about a lesion on the vocal cord, a biopsy procedure under general anesthesia is recommended.

Sources:
http://the-sun.on.cc/cnt/news/20100621/00410_012.html

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