聲帶息肉

電視歌唱比賽節目掀起熱潮，不少人日夜苦練歌藝，惟若發聲方法不當，可致聲帶出血及發炎，形成血泡及水腫，令聲音沙啞、走音及失聲。若反覆勞損，會令聲帶長出息肉及生繭，聲調會變沉甚或致「豆沙喉」，需切除病變組織。

聲帶受損會令聲音沙啞、喉嚨痛、說話時無氣無力、無法提高音量及說長句子、無法控制音調高低，嚴重的更會失聲。輕微勞損個案只需減少說話及多喝暖水，讓聲帶充分休息便可復原。若情況持續兩日以上，便可能是聲帶出現血泡或水腫 (polyp) ，應考慮求醫，服用消炎藥後，一般亦可在數天內康復。然而，約一成個案未必能完全復原，患處或會長出息肉及結節等；若聲帶長年累月勞損，兩側聲帶會結繭，聲音會逐漸變沉甚至變成「鵝公喉」，或須考慮以微創手術清除息肉及厚繭。

Benign vocal lesions such as polyp, nodule, or cyst often result from chronic vocal abuse. These lesions affect the normal vibratory movement of the vocal cords and could lead to hoarseness, sore throat, lowering of pitch, dysphagia, or even shortness of breath. Diagnosis is through flexible fiberoptic examination and video stroboscopic examination in the clinic setting. Early treatment is medical including voice rest, speech therapy, and hydration. Persistent symptomatic vocal lesions require endoscopic excisional biopsy under general anesthesia. Patients with smoking, alcohol history or family history of throat cancer are at risk for laryngeal cancer and are recommended to undergo excisional biopsy for suspicious lesions.

Sources:
http://the-sun.on.cc/cnt/news/20100711/00410_030.html

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