Vocal cord disease develops when voice strain continues. Several permanent pathological changes can occur: vocal cord nodules and later vocal cord polyps can develop, which have the potential to change the voice quality permanently.
Other changes are granulomas, which is a focus of inflammatory tissue. This can bleed with further voice strain, lead to coughing and chronic attempts to clear the throat. Other pathology that may be found in these cases is a vocal cord cyst. At this point it is best to have the patient referred to an ENT specialist as laryngoscopy with a fiberoptic instrument likely needs to be done to visualize, possibly biopsy and treat these lesions. Smoking cessation and anti-acid reflux medicine, if applicable, will also likely be prescribed (Ref. 2, p. 1763).
You may not have thought much about these conditions of the throat, but when one of your favorite singers has to cancel a concert it is very likely that this is what is going on with their throat. Here is an article that lets you look behind the scene (thanks to abcnews.go.com/blogs/health for this link) of some famous singers.
Here is an extensive review of hoarseness of the voice (thanks to www.aafp.org/afp for this link) including voice strain. Here is another link to a site with many laryngoscopy images.(thanks to www.ghorayeb.com for these images).
1. James Chin et al., Editors: Control of Communicable Diseases Manual, 17th edition, 2000, American Public Health Association.
2. Behrman: Nelson Textbook of Pediatrics, 16th ed., 2000, W. B. Saunders Company
4. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001 Mosby, Inc.
5. Abeloff: Clinical Oncology, 2nd ed.,2000,Churchill Livingstone, Inc.
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier