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After your Epley manoeuvre — patient information leaflet

  What this leaflet tells you This leaflet explains what to expect after the Epley (canalith repositioning) manoeuvre for posterior-canal BPPV, what you should and shouldn’t do, and when to seek help.   1. Quick summary — what the Epley did The manoeuvre moves tiny particles (otoconia) out of the balance canal of your inner ear and back into a place where they don’t cause spinning (vertigo). Most people feel much better after one or a few treatments. However BPPV can come back (recurrence is common).   2. How you may feel immediately afterwards You may feel dizzy or off-balance for a few minutes to a few hours; nausea is possible.   Some people feel better straightaway; others get gradual improvement over days.   Rarely ,you may have brief recurrences of vertigo — this does not always mean the manoeuvre failed.   3. Activity and posture — what the evidence says Good news: High-quality studies and recent guidelines show that strict he...

Hoarseness or change in voice...



When should I get worried about my change in voice?
Change in voice can be due to so many causes. It can be due to simple things like acid reflux, chronic cough, flu, post nasal drip leading to frequent throat clearing or due to cancer on the voice box. 

"IF YOU HAVE CHANGE IN VOICE WHICH IS GETTING WORSE FOR MORE THAN 3 WEEKS, YOU NEED TO SEE AN ENT SURGEON."

Other symptoms which can be present with a change in voice in cases of laryngeal cancer be weight loss when you are not dieting, a lump in the throat, earache, shortness of breath, throat pain.


How does the ENT surgeon diagnose what is causing my hoarseness?

Change is voice can be due to both non-cancer and cancerous reasons. On a visit to ENT voice specialist, he or she will take a full detailed history, access how your profession is affecting your voice and how voice change is affecting your job. After recording your quality of sound, an endoscope (a thin tube with a camera attached) is used to examine any structural and functional problems with the voice box. In some cases, examination under general anaesthetic with biopsy may be requested along with special scans of neck and chest.

What are non-cancer causes of hoarseness?

Common causes for the change in voice could be due to
 a) due to an increase in muscle tension in neck or voice box (e.g. stress, singing or speaking without a warm-up and in an inappropriate way),
b) inflammation of the voice box (e.g. smoking, laryngitis due to flu, acid reflux, post nasal drip due to hay fever or sinusitis),
c) due to structural problems in voice box itself (e.g. nodules, cysts, blood cyst or bleeding in vocal cord, polyp),
d) rarely due to nerve compression or thyroid.


I relly on my voice for my job, how can I look after my voice?
Professionals like teachers, doctors, singers need their voice to earn their living. If someone gets hoarseness, that means your voice box needs to be looked after. Our voice quality depends on vibration in vocal cords in the voice box and our lungs in the chest. Things we all can do to look after our voice are keeping ourselves and vocal cords well hydrated by drinking plenty of water every day. 

If you drink a lot of juice, tea, coffee, fizzy drinks; change these episodes gradually by drinking water. It is recommended we all should drink at least 2 litres of water every day. Keep your surroundings hydrated by using air moisturiser, steam inhalation, keeping rooms well ventilated and not using too much of air conditioner. 

Smoking is harmful to the voice. Seek help from your GP and "stop smoking helpline". Seek advice from your GP or ENT surgeon how to treat your acid reflux or post nasal drip from hay fever or sinusitis. Constant throat clearing can damage your voice box. Specific to teachers and stage performers, use personal amplification systems. Reducing background noise can have a considerable impact, as well. Breathing exercises in yoga and pilates help with your lungs and voice projection. Seeking advice from ENT voice specialist, who can help you identify the cause for your hoarseness and arrange to see speech and language therapist for vocal training.




I saw an ENT surgeon, and he told me I have vocal cord nodules. I am a singer what to do?
Vocal cords have two layers deeper muscular layer and a top layer of gel. Gel layer vibrates similar in a similar way when you see a ripple if wave on the surface of the water which is struck by a stone.  When a singer hits the vocal cord in high or low notes, this can cause stress on the gel layer to form nodules. Initially, it is soft collection hence the name soft nodule, and if we continue to use voice without changing our singing habits, this can be replaced by fibrous tissue to form a solid nodule. Once you reach the stage of the solid nodule, it has to be treated surgically. Soft nodules are best managed by getting help from your ENT surgeon, speech and language therapist and singing teacher. Hydration, the good warm-up session before a stage performance, and voice rest are critical in treating soft nodules.


Mr Gaurav Kumar

Consultant Ear Nose Throat Surgeon

To make an appointment

Call 07494914140

email  info@entsurgeonclinic.co.uk


Disclaimer: For general information only, always seek medical advice from your treating consultant

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