What is contained in the vocal fold. Human vocal fold anatomy - information

The most characteristic for this form of dysarthria are: 1) weakness of the articulatory and respiratory muscles, especially the diaphragm, hypokinesia of the laryngeal muscles; 2) pareticity of the lingual, labial muscles, soft palate.

With the spastic-rigid form of dysarthria, there is a significant change in muscle tone along with the phenomena of spastic paresis. When attempting arbitrary speech, muscle tone sharply increases in the articulatory, respiratory and vocal apparatus.

The most characteristic signs of this form of dysarthria are: 1) tension of the respiratory muscles; 2) hyperkinesia of the larynx; 3) spastic paresis in the lingual, labial muscles, soft palate, which leads to monotony, nasalization of the voice.

Thus, in the spastic-rigid form of dysarthria, the rhythmic-melodic-intonation side of speech suffers due to asynchrony in the activity of the articulatory, respiratory and vocal apparatus, which is associated with the tension of the phonator muscles.

In the spastic-hyperkinetic form of dysarthria, the phenomena of spastic paresis are combined with athetoid and choreic hyperkinesis. Articulatory movements are disordered, chaotic, non-localized, arrhythmic.

Voice disorders in extrapyramidal disorders were described by M. Zeeman, calling them extrapyramidal phonatory syndrome. M. Zeeman notes a characteristic violation of breathing, voice and all melodic coloring of speech in this syndrome. So, breathing, usually shortened, accelerates in the affective state of the patient, asynchrony appears between the chest and abdominal respiratory movements (reminiscent of breathing during stuttering). The voice changes in strength and duration of sound due to hyperkinesia or hypokinesia of the larynx, respiratory failure. There is a noticeable reduction in the phonatory period - the voice fades after 3-5 s, the patient takes frequent breaths. The timbre of the voice acquires a nasal sound due to the retraction of the raised soft palate from the posterior pharyngeal wall. But, as M. Zeeman notes, rhinophony is not permanent, it increases towards the end of a phrase or towards the end of phonation. Such speech is characterized by monotony, monodynamism and tempo disturbances (its acceleration or deceleration), therefore, in order to avoid diagnostic errors, differential diagnosis with stuttering is necessary. In addition, the voice may be aphonic or dysphonic with laryngeal hyperfunction, muffled, excessively loud, difficult to control. These children usually do not have a singing voice, they cannot sing.

The most characteristic signs of the spastic-hyperkinetic form of dysarthria are:

• 1) hyperkinesis of the respiratory muscles, which cause its tension or, conversely, weakness, lethargy; the consequence of this phenomenon is a weak, quiet voice, constantly exhausted, intermittent;
• 2) dyskinesia of the larynx, which causes, on the one hand, squeezing of the voice, and on the other hand, its trembling and vibration;
• 3) spastic paresis of the lingual, labial muscles in combination with hyperkinesis, which gives the voice a monotonous tone with cries and an increase in voice; the phonetic side of speech usually suffers slightly.

Thus, in the spastic-hyperkinetic form of dysarthria, the potential for voice formation is much higher than their implementation in the speech stream. In the process of arbitrary phonation, hyperkinesis intensifies, in connection with which the sonority of the voice is reduced, its strength is depleted and speech intelligibility decreases. The melodic-intonational side of speech suffers to a large extent and is difficult to correct.

With atactic form of dysarthria, articulatory movements lose their accuracy and coordination. Against the background of a decrease (hypotension) of muscle tone, its increase can be observed. Speech is slurred and somewhat slow. The voice is monotonous, unmodulated, intermittent, hoarse. Pitch modulations and changes in strength are not available, with non-speech phonation the voice is strong, sonorous.

So, dysphonia various forms dysarthria in children is characterized by a peculiar and complex violation of the pitch, strength and timbre of the voice with many neurodynamic layers. The characteristic of dysarthria is complicated clinical syndromes children's cerebral palsy. The main cause of the voice disorder in some cases is asynchrony in the activity of the articulatory, respiratory and vocal apparatus, and in others - the paresis of the movements of the vocal folds and articulatory motility. Studying voice disorders can be important diagnostic sign determining the form of dysarthria in children.

To the peripheral organic disorders voices include voice disorders associated with pathoanatomical changes in the larynx, extension tube and hearing loss.

With pathoanatomical changes in the extension tube, rhinolalia and rhinophony are observed. Differential Diagnosis rhinolalia and rhinophony is not a significant problem. Rhinolalia is pathological change voice timbre and distorted pronunciation of speech sounds; rhinophonia - a change in tone, voice timbre, due to a violation of the relationship between the nasal cavity and the oropharyngeal resonator during phonation without articulation and pronunciation disorders.

Rhinolalia and rhinophony take place in speech pathology and are manifested by a peculiar violation of the timbre of the voice and the phonetic side of speech.

Many speech therapists in the study of patients with open rhinolalia after uranoplasty surgery reveal a significant impairment of their voice function. The voice is deaf, unmodulated, with a sharp nasal tone. As a result of air leakage during speech through the nose, rhinolalics delay it not in places of normal articulation (labial closure when pronouncing sounds p, b, lingo-palatine with t, d, k, d), but on the vocal folds, which gives the speech a guttural character.

Rhinolaliks, embarrassed by their speech, try to speak more quietly, as a result of which the voice becomes monotonous, weak, muffled. M. Zeeman calls voice disorders during cleft palate dysphonia palatina or palatophonia, in contrast to articulatory disorders, i.e. palatolalia. The author points to two causes of palatophony: laryngeal hyperfunction and abnormal vocal resonance. “The voice arises with strong expiratory pressure on the glottis and increased tension of the vocal cords. At the same time, the larynx rises strongly and the extension tube contracts ... The voice is formed primitively and squeezed ... ”M. Zeeman connects the change in the timbre of vowels with a number of anatomical and resonator reasons, as well as with incorrect movement of the tongue and larynx. Moreover, the older the child, the more noticeable and unpleasant the palatophony.

The Polish logotherapist A. Mitrinovich-Modrzeevska notes that rhinophony can be accompanied by rhinolalia in the following cases: 1) if acquired factors (for example, degenerative changes sensitive and trophic nerve fibers pharynx, dysfunction of the muscular system of the respiratory, phonation and articulatory muscles) begin to exert their influence in the first years of a child's life, when the articulatory mechanisms are not yet fully formed; 2) if there is also a hearing impairment; 3) if there are also violations of articulation of central origin.

The method of X-ray cinematography confirmed the assumptions of A. Mitrinovich-Modrzeevska: in rhinolalia, the function of the vocal folds is characterized by asymmetry and asynchrony. There are also functional disorders of the respiratory muscles, and especially the diaphragm, their lethargy, lack of coordination with phonation and articulation. The sound of vowels changes relatively little, fricative and occlusive-fricative consonants are most distorted. The height and intensity of the frequencies that make up the spectrum of a given sound changes with rhinolalia: the sound goes down, its intensity decreases. Even after successful operation and phoniatric treatment, the voice of these patients is characterized by vocal inferiority, they are not able to produce vocal efforts.

T.N. Vorontsova notes a violation of the height, strength and timbre of the voice with rhinolalia. The voice is deaf, with a sharp nasal tone, monotonous, unmodulated, weak. When determining the degree of nasality, the author uses the following terms: sharply nasalized speech and speech with slight nasalization. Investigating the voice function in these patients using the analysis method, T.N. Vorontsova revealed a sharp decrease in the envelope of the spectrum in the range of 2000-3000 Hz. All format areas, except for the main tone, are not clearly expressed.

The voice disorder is largely determined functional disorder respiratory function with rhinolalia. These patients are characterized by a short superficial breath, a small volume of inhaled air and a large loss of exhaled air through the nasal passages.

The soft palate is involved in the formation of the closing pharyngeal ring (or palatopharyngeal closure) - it moves back and up until it contacts the Rassavant roller, while the muscles of the lateral walls of the pharynx on both sides close the pharyngeal ring. The uvula rises and creates a complete isolation of the nasopharynx from the oropharynx. With insufficient functioning of the muscles involved in the formation of the pharyngeal ring, most of the air penetrates into nasal cavity, since the distance between the back wall of the pharynx and the soft palate exceeds 5-6 mm. The main value is the length of the soft palate, and to a lesser extent - its mobility. The function of the palatopharyngeal closure is also influenced by the degree of mouth opening and the position mandible, which changes the shape and size of the oropharyngeal resonator, and, consequently, its acoustic tuning and the pitch of formant vowels.

There is a close functional relationship between the soft palate and the larynx, and between the pharynx and larynx. The slightest change The position of the soft palate causes a change in the position of the vocal folds. Irritations of the receptors of the nasal cavity and especially the mucous membrane of the soft palate affect the voice-forming apparatus. The receptors of the soft palate (especially the uvula) transmit impulses to the central nervous system, as a result of which the system of the oronasopharyngeal resonator associated with it is aligned with the function of the soft palate (the reverse afferentation mechanism operates).

In addition, there is a relationship between the muscles of the closing pharyngeal ring and the respiratory muscles (especially the diaphragm), which form a single unit during phonation. propulsion system. With tension of the vocal folds and respiratory system the soft palate is inactive; with uniform respiratory movements, lightness, sonority of the voice, the fluctuations of the vocal folds are uniform and the soft palate is mobile.

Thus, a violation of the function of the soft palate (regardless of the causes that cause it) leads to a violation of coordination in the activity of the energy, generator and resonator systems and to a decrease in the regulatory role of the central nervous system. There is a fixation of the pathological reflex of voice formation, which complicates speech therapy work even with favorable anatomical and physiological data (i.e., after the elimination of the causes that caused nasalization).

Nasalized phonation can be attributed to dysphonic disorders of voice formation, violation of the pitch, strength and timbre of the voice. But hallmark disphonia palatina is a predominant violation of the timbre of the voice. Nasalization deprives the timbre of pleasant modulations, pitch changes, sonority and flight of the voice. In addition, there is a weakness of the voice, a tendency to its excessive increase, a clamped, stifled sound, sometimes hoarse and hoarse. The muffled, dull, dead sound of the voice impoverishes the natural intonations, the melody of speech, and reduces its expressiveness. The patient finds it difficult to convey the main intotones - questions, statements, exclamations, surprise, amazement (emotional intonations), commands, beliefs, requests (volitional intonations), narrative, enumeration, indifference (logical intonations). Raising and lowering the tone, amplifying and weakening the sound are almost inaccessible to children suffering from rhinophony.

Thus, with rhinophony, the main link of speech expressiveness is violated - voice modulations, which leads to a disorder in the melodic-intonation side of the child's speech.

There are two types of rhinophonia - open (rhinophonia aperta, hiperrhinophonia) and closed (rhinophonia clausa, huporhinophonia) (see Table 3 on p. 40).

Open rhinophony is due to organic (congenital and acquired) and functional causes.

Organic congenital open rhinophony occurs with congenital shortening of the soft palate, which is a sign of a malformation - the ratio of the lengths of the hard and soft palate is 3:1 or even 4:1 (instead of the normal 2:1).

Organic congenital open rhinophony may be the result of open rhinolalia resulting from splitting of the hard and soft palate. In this case, open rhinophony is manifested only by a violation of the timbre of the voice without phonetic defects.

Thus, the involvement of a conscious-arbitrary level of regulation of speech activity improves the child's intonation capabilities. But speech is highly automated motor function, so it is important to translate voluntary control into unconscious-involuntary.

Acquired organic open rhinophony occurs with acquired paresis and paralysis of the soft palate, myasthenia gravis, perforations, fistulas of the hard or soft palate caused by injury, tuberculosis, syphilis. Open rhinophony can be an unpleasant consequence of tonsillectomy when postoperative scars tighten the soft palate and limit its mobility. Unfortunately, such an undesirable postoperative effect is quite common.

An unsuccessful operation can cause open rhinophony associated with scarring of the soft palate. Sometimes the function of the soft palate is restored spontaneously, but the rhinophony is preserved due to the prevailing pathological reflex of voice formation (transforms into a functional habitual form). In this case, you also need speech therapy classes to eliminate nasalization.

The most common cause of open rhinophony is peripheral and central paresis and paralysis of the soft palate. Peripheral paralysis and paresis occur after diphtheria, influenza, with damage to the motor branches of the glossopharyngeal and vagus nerve, with injury or tumor pressure. At the same time, hoarseness and aphonia are also observed due to dysfunction of the internal muscles of the larynx.

Central paralysis or paresis of the soft palate is relatively rare. It should be distinguished from peripheral paralysis: in peripheral paralysis, the soft palate is motionless, not only phonation is disturbed, but also swallowing, fluid passes into the nose; with central paralysis, the mobility of the soft palate is limited during phonation, but its reflex movements during swallowing are preserved. Pseudobulbar paralysis can be accompanied by both peripheral and central (with erased forms) paralysis of the soft palate (congenital and acquired).

Rhinophony manifests itself in a peculiar way in diseases of the extrapyramidal system: rhinophony is not permanent - stronger towards the end of phonation or towards the end of a phrase, sometimes turns into a closed one, which again turns into an open one. Extrapyramidal rhinophony is not associated with a violation of the innervation of the soft palate. This is due to the retraction of the raised and tense soft palate from the posterior pharyngeal wall. During phonation, not only the muscles that raise the palate work, but also their antagonists. Depending on the tension of the muscle that raises or lowers the palate, hyperrhinophonia or hyporhinophonia (extrapyramidal phonator syndrome) occurs.

Functional open rhinophonia occurs for a number of reasons. Sometimes it appears in weak, asthenic children with sluggish articulation, in which the soft palate does not reach the back of the pharynx. Functional open rhinophony may be the result of hysterical reactions that appear as a result of mental trauma, fright, fear. The resulting hysterical muscle paresis, and, accordingly, rhinophony, are transient. Habitual functional open rhinophony is observed after the past post-diphtheria paralysis of the palate, removal of adenoids, choanal polyps, tumors of the nasopharynx, peritonsillar abscess, etc. Such a violation occurs as a result of forgetting the idea of ​​movement, the loss of the kinesthetic support of movement (in this case, the soft palate) or due to the creation of new physiological conditions for the formation of speech sounds. So, after extirpation of tumors of the nasopharynx, due to insufficient differentiation of oral and nasal exhalation, the air stream begins to penetrate into the nasal cavity when pronouncing not only nasal, but also oral sounds.

Functional unstable open rhinophony is observed with hearing loss. Its appearance is associated with inaccurate articulation, including inaccurate palatopharyngeal closure.

Voice with open rhinophony is disturbed in varying degrees depending on the reasons that caused it, and most importantly - on the usefulness of the function of the soft palate, its mobility and length. The specific acoustic features of a nasalized voice sound are explained by the amplification of the fundamental tone and low tones.

vocal fold(lat. plica vocalis) - a fold of the mucous membrane of the larynx, protruding into its cavity, containing the vocal cord and vocal muscle. The vocal folds originate from the vocal processes of the arytenoid cartilages and insert on the inner surface of the thyroid cartilage. Above the vocal folds, parallel to them, are the folds of the vestibule (false vocal folds). In professional lexicon (and in older speech therapy manuals), speech therapists often use the term "vocal cords" or "ligaments" instead of "fold".

True vocal folds- two symmetrically located folds of the mucous membrane of the larynx, protruding into its cavity, containing the vocal cord and vocal muscle. True vocal folds have a special muscular structure, different from the structure of other muscles: bundles of oblong fibers go here in different mutually opposite directions, start at the edge of the muscle and end in its depth, as a result of which true vocal folds can fluctuate both with their entire mass and with one some part, for example, half, third, edges, etc.

False vocal folds(vestibular folds, vestibular folds) - two folds of the mucous membrane that cover the submucosal tissue and a small muscle bundle; Normally, the false vocal folds take some part in the closing and opening of the glottis, but they move sluggishly and do not come close to each other. False vocal folds acquire their significance in the development of a false ligamentous voice and guttural singing.

Diseases of the vocal cords. Imagine that the vocal cords are strings. What happens if the strings are loosened? That's right, they won't wobble and they won't be playable. At acute inflammation larynx (laryngitis) vocal cords may be involved in the process. The vocal cords become inflamed, increase in size, the glottis decreases, and sometimes completely closes, air from the nasopharynx does not enter the lungs and the person begins to choke. This formidable complication of the vocal cords most often occurs suddenly with viral diseases, allergies, voice strain, inhalation of irritants and requires emergency medical care. Therefore, with the sudden appearance of hoarseness, especially in children, you should immediately consult a doctor - an otolaryngologist. With overload of the vocal cords, chronic allergic diseases larynx, constant inhalation of irritating substances, such as tobacco smoke, in the area of ​​the vocal cords, there may be a constant swelling of the mucous membrane, leading to hoarseness and changes in the timbre of the voice. With such symptoms, an immediate appeal to the otolaryngologist is necessary to exclude oncological diseases.

The diagnosis is based directly on the clinical examination. A comprehensive examination may be needed to determine the cause. There are several surgical approaches for the ineffectiveness of conservative therapy.

Unilateral vocal cord paralysis is the most common. About 1/3 of unilateral paralysis is of neoplastic origin, 1/3 of traumatic origin, and another third is of idiopathic origin. Nucleus ambiguus paralysis may result from intracranial tumors, vascular diseases and demyelinating processes. Paralysis of the recurrent nerve of the larynx occurs with diseases of the neck or chest, trauma, thyroidectomy, poisoning with neurotoxins (lead, arsenic, mercury), neuroinfections (diphtheria), trauma to the neck or spine, as well as during surgical interventions, Lyme disease and viral infections. Most idiopathic cases are most likely caused by viral neuronitis.

Symptoms and signs of vocal cord paralysis

Paralysis of the vocal folds leads to impaired adduction and abduction of the folds. With paralysis, phonation, breathing and swallowing are disturbed, and aspiration of food and liquid into the trachea can also occur. With unilateral paralysis, the voice may be hoarse and hoarse, but the airway is usually not obstructed because the healthy fold moves normally. With bilateral paralysis, both folds are located 2-3 mm from the midline, and the voice sounds normal, but the sound intensity is limited. This disrupts the permeability respiratory tract, which leads to the development of stridor, dyspnea with effort, since each ligament is brought to the midline of the glottis due to the Bernoulli effect. Aspiration is also a danger.

Diagnosis of vocal fold paralysis

• Laryngoscopy.
• Various research methods depending on the cause of the disease.

Diagnosis is based on laryngoscopy data. It is always necessary to find out the reason. Assessment of the patient's condition is carried out in accordance with the anamnesis and clinical examination data. When taking an anamnesis, the doctor always asks about the presence of peripheral neuropathies, including possible contact with heavy metals. Further examination may require CT or MRI, ultrasound, gastroscopy and bronchoscopy. It is necessary to differentiate paresis of the vocal folds of a neuromuscular nature and cricoarytenoid arthritis, in which fixation of the cricothyroid joint may occur. Fixation of the cricothyroid joint is best detected by assessing passive movement during direct laryngoscopy under conditions general anesthesia. Cricothyroid arthritis can occur when rheumatoid arthritis, external blunt trauma of the larynx and prolonged endotracheal intubation.

Treatment of vocal fold paralysis

To increase the volume of the fold, a paste with plasticized particles, collagen, micronized dermis, own fat is injected into it, which makes it possible to bring the vocal folds together, improve voice formation and prevent aspiration.

Medialization is the displacement of the vocal fold to the midline by introducing a special adjustable implant laterally from the affected fold. This procedure can be performed under local anesthesia to adjust and correctly position the implant according to the change in the patient's voice. Unlike a paste with plasticized particles that permanently fixes the crease, the implant can be adjusted and changed.

Reinnervation has become effective only in recent times.

A permanent or temporary tracheostomy may be required (only for URT infection). Arytenoidectomy with lateralization of the true vocal folds is also used, which allows opening the glottis and improving airway patency, but may have the opposite effect on voice quality. An alternative to endoscopic and open arytenoidectomy can be posterior laser cordectomy, which allows you to open the posterior glottis. After successful laser expansion of the posterior glottis, the issue of the need for a long-standing tracheotomy should be decided.

The vocal cords are important anatomical structures for humans that are responsible for functions such as voice and protection of the lungs and bronchi from water, food or other foreign objects entering them. Ligaments are located in the middle part of the pharynx on its left and right sides, stretched in the center.

Anatomical features

• the true vocal cords are two symmetrical folds of the mucous membrane of the larynx containing the vocal muscle and ligament. They have an individual structure that differs from other muscles;
• false vocal cords are also called vestibular folds, as they are located in this area. They cover the submucosal tissue and the muscle bundle. They take some part in closing and opening the glottis. But their true functions are manifested only in guttural singing and in the development of a false-ligamentous voice.

Mystery of the Voice

The larynx, and accordingly the vocal folds, are organs and anatomical structures that depend on the level of hormones. Hence there is a difference in voice between men and women. In childhood, the voices of girls and boys sound about the same, but with the advent of adolescence, the voice mutates, this feature is associated with a change in hormonal levels. Under the influence of male hormones, the larynx expands and lengthens, and the ligaments thicken. Due to such changes, the voice becomes rougher and lower. After the onset of adolescence in girls, the larynx undergoes very minor changes, due to which the voice remains high and sonorous.

In some cases, there are atypical voices for sounding in men or women. Such phenomenal exceptions occur due to a genetic mutation or as a consequence of an imbalance of hormones.

With the advent of old age, voice changes are also noted, it becomes rattling and weak, this all happens due to the fact that the ligaments stop closing to the end, as they become thinner and weaker. The deterioration of their function is also associated with insufficient production of hormones, which are practically not produced after the onset of the aging period.

• hypothermia;
• professions that require constant speech (teachers, actors, etc.);
• diseases of the larynx, the treatment of which was not made in a timely manner.

Interesting fact! Speakers who speak continuously for 2-3 hours must rest their vocal cords for the next 8-9 hours, this is how long it takes for them to recover, otherwise hoarseness or hoarseness of the voice threatens.

Diseases

Unfortunately, like any other organ, the vocal cords are subject to various pathologies under the influence of various causes. Pathologies can be of a different nature, for the treatment of some it is enough to carry out simple manipulations and rest the voice, for other diseases it will be required surgical intervention and long-term rehabilitation.

• A granuloma is a benign growth that can result from trauma.
  larynx or with systematic irritation of the ligaments. The manifestations of granulomas include hoarseness, a sense of presence foreign body in the larynx desire to expectorate it. Also granuloma, a formation that can cause pain, as a result of her constant irritation when talking. Pain can occur not only in the larynx, but also give to the ear on the side of the lesion. Outwardly, the granuloma is a pale pink formation, it can be located both on a wide footboard and on a thin one. The formation tends to grow as long as it is irritated, and in the case of the vocal cords, this action is irreversible. Regarding treatment, surgical intervention is carried out only after all conservative methods have not been effective. For conservative treatment it is important to eliminate the cause of the irritating factor, to create complete voice rest. If the granuloma is not irritated over time, it will resolve itself;
• vocal cord nodules are benign growths that occur as a result of constant overload of the vocal cords. Most often formed in middle-aged women, as well as in people whose profession is related to singing or oratory. After frequent overloads, seals form on the folds that resemble calluses; with continued loads, they continue to increase in size. The pathology has no special symptoms, only a painless hoarseness of the voice can appear, which disappears after a short rest. The basis of treatment is voice therapy, with the use of steroid drugs to reduce swelling of the folds of the larynx. But after another overload of the ligaments, the nodules may reappear, the disease is chronic. In some cases, it is proposed to remove the nodules with a laser or cryosurgical methods;
• polyps are benign formations that are localized, as a rule, in the middle of the vocal folds. Signs of polyps are hoarseness, sometimes a feeling of having a foreign body in the throat. Polyps have clear edges, mostly red, the structure of the growth can be lobular or have a smooth surface, the sizes can be different. The cause of polyps is mainly trauma to the larynx and ligaments. As well as nodules, the treatment of polyps is based on voice therapy, if it is not effective, they resort to surgical intervention;
• spastic dysphonia is manifested in involuntary movements of the vocal folds. The causes of such disorders are most often mental disorders, severe stress or overload of the ligaments. The disease is inherited, more often affects people 30-40 years old. Spasmodic dysphonia is characterized by tightness and unnaturalness of the voice. Pathology consists in limiting the motor function of the vocal cords. The most commonly used treatment is injections. special preparations in the area of ​​ligaments. Unfortunately, it is not possible to completely cure the pathology, but only to improve the patient's condition. If after the injections the proper result is not obtained, surgery may be prescribed;
• phonasthenia, pathology, expressed in a weak closure of the folds. It occurs due to overload of the vocal cords or fatigue of the nervous system. The main treatment for phonasthenia is silence. At chronic course diseases without treatment may develop complete aphonia, that is, loss of voice;
• Cancer of the vocal cords is perhaps the most difficult disease that requires immediate treatment. The exact causes of its development have not been established, but it is known that smoking and drinking alcoholic beverages are factors influencing the occurrence of atypical cells. Also malignant tumor can be reborn as a result of the lack of treatment of precancerous diseases, for example, after polyposis. Treatment is prescribed individually, as a rule, it is surgical in nature, tumor removal is required, as well as radiation exposure.

As you can see, the vocal cords are the main instrument that allows us to speak. But, not only the ability to speak, but also the protection of the respiratory tract depends on their work, since the folds block the path for accidentally falling crumbs or water to enter the lungs or bronchi. Most often, people who have to talk a lot and loudly, singers, actors, teachers, face violations of the functionality of these anatomical structures. They are more prone to the risk factor for the formation of diseases of the ligaments, to prevent them, you should follow the voice mode and give proper rest to the ligaments. In this case, they will reward you with uninterrupted voice work without hoarseness.