老師聲音啞 小心長繭Long mute the voice of teachers be careful cocoon

老師聲音啞 小心長繭 【洪家愉】9年前黃秀雲發現自己講話時常有好幾個字發不出聲音，看醫生後才知道，聲帶長了息肉了。 術後復健 聲音失而復得 在幼教界服務了30年，目前擔任台灣大安附幼園長的黃秀雲因為長時間說話，以及發聲方式不正確，導致右側聲帶長出息肉，且病程已非初期，無法透過休息和用藥來改善，只有在全身麻醉下，接受內視鏡手術，才能挽救她的聲音。 原本說話聲音就比較低的黃秀雲，術後變得更加低沉，但她很珍惜失而復得的聲音，術後接受3個月的音聲復健，學習運用正確的發聲方式講話，感覺喉嚨不舒服就立即就醫，用更實際的行動寶貝自己的喉嚨。 習慣大喊 長期忽略喉嚨 黃秀雲回想，自己聲帶之所以會長出息肉，除了習慣只用喉嚨說話外，她的工作環境，讓她時常在看見學童奔跑、跌跤或陷入危險時，不自禁大聲呼喊，才會讓聲帶長期不舒服。初期說話後，會有說話氣不夠、喉部肌肉發緊和喉嚨痛的感覺，但情況在休息過後總會有些許改善，加上生活忙碌而疏忽這些症狀。 原因 過度使用 發音習慣不好 絕大多數的老師，工作時都需要講很多話，也因此聲帶長繭和聲帶息肉好發在教師族群。 台北市立聯合醫院仁愛院區耳鼻喉科主任黃弘孟就說，聲帶長繭好發於過度使用聲帶、發音習慣不良、沒有讓聲帶獲得適當休息、補充水分的人身上。 台北萬芳醫學中心耳鼻喉科主治醫師吳佳哲也表示，女性聲音尖，聲帶振動頻率較男性高，容易疲勞。常需大聲講話的老師們，也是危險群。過度使用的聲帶，會有慢性發炎和疲勞的情形，且聲帶前三分之一磨損情況最厲害。 聲帶會出現息肉，通常與突然大聲說話造成的突發性傷害和出血有關，與長繭不同的是，息肉可以只發生在單側聲帶。 預防 用輔助器具 多喝水潤滑 台北市立聯合醫院仁愛院區耳鼻喉科黃弘孟主任建議，聲帶疾病明確好發於聲帶使用過度的族群，因此如果有必要多說話或大聲說話，應盡量使用麥克風等輔助器具加大音量，每隔一段時間停止說話，讓聲帶休息，飲水濕潤聲帶，讓聲帶在互相摩擦時，有水分參與潤滑。 另外，萬芳醫學中心耳鼻喉科主治醫師吳佳哲也提到，正確的發聲方式，是以穩定而緩慢的腹式呼吸，讓聲音更持久，音量更平均；說話時情緒放輕鬆、速度放慢，音量降低，多運動增加肺活量，並且要有充足睡眠讓聲帶休息，在乾燥的環境中少講話、多喝水，不喝咖啡、太冰、太熱的飲料和辛辣食物，以免刺激聲帶，造成發炎。 治療 初期即就醫 可免挨一刀 黃弘孟主任指出，聲帶長繭或息肉，都會讓聲帶在發聲時，因為中間有障礙物，無法確實關閉，在肺部出氣量固定的情況下，聲門漏氣使患者感覺說話吃力，必須用更大的力氣才能維持相同的音量。 但此時若能立即就醫，嘗試以適當音量說話並多休息，繭是會消失的；但若光以喉部肌肉更加用力的錯誤方式來提高音量，久而久之，反而會使聲帶摩擦變劇，而受阻的聲帶無法接觸摩擦，則會令聲音變沙啞，且持續破壞的下場，最後只有手術一途。 治療上，一般醫師會視聲帶息肉和長繭的病程來決定處理方式，假設位於病程初期，通常會以簡單的藥物，以及多休息、並修正錯誤發聲習慣的方式來改善，如果情況嚴重至息肉已經長得很成熟、繭已經很厚，就必須透過顯微手術來改善問題。 2008-10-02 Long mute the voice of teachers be careful cocoon Discovery】 【Hongjiadu 9 years ago, Huang Xiuyun speech often find themselves unable words sound good to see a doctor to know, the long polyps of the vocal cords. Postoperative rehabilitation regained voice Childhood education services in the community for 30 years and currently serves as director of the Taiwan Fu You Da Huang Xiuyun speak for a long time because, as well as the voice incorrectly, causing the right side of the vocal cord polyps grow, and the course has been non-early days of rest and medication can not come Improved only under general anesthesia, and endoscopic surgery to save her voice. Original voice to speak on the relatively low Huang Xiuyun, after more deep, but she was the voice of the treasure found again, to accept after 3 months of voice rehabilitation, learning to use the correct way of speech, voice, throat does not feel Medical treatment immediately comfortable, more practical actions treasure their throat. Shouted used to overlook the long-term throat Huang Xiuyun recall, was president of his own vocal polyps, in addition to customary throat only to speak, her work environment so that she often saw students running, or falls into a dangerous, Buzi Jin cry, so that only vocal cords Long-term discomfort. After the initial remarks, there will be enough gas to speak, made the throat muscles and sore throat feel tight, but after the break in the Federation to improve slightly, together with the busy life of neglect and these symptoms. Reason Excessive use of a bad pronunciation habit The vast majority of teachers, work, we need to talk a lot, so long cocoon vocal polyps and vocal teachers in the group made good. Taipei Municipal United Hospital Charity Hospital ENT district director of the Hung-Meng Huang said that the announcements made good on the long cocoon excessive use of vocal cords, sounds bad habits, there is no vocal cords so that adequate rest, add the water people. Wan Fang, Taipei Medical Center Otolaryngology physician Wu Jiazhe also said that female voice sharp, vocal cord vibration frequency higher than men, easily fatigue. Often need to speak loudly teachers, but also risk. Excessive use of the vocal cords, there will be chronic fatigue and inflammation of the situation, and one-third of the vocal cords before the most wear. There will be vocal polyps, and are usually caused by a sudden loud and sudden bleeding injury, and long cocoon difference is that polyps can occur only in unilateral vocal. Prevention Assistive devices used to drink plenty of water lubrication Taipei Municipal United Hospital Charity Hospital District Mengzhu Ren Huang Hong ENT suggested that a clear vocal cord disease occurred in the use of excessive vocal group, so if it is necessary to speak more loudly or speak, to make full use of a microphone, and other assistive devices to increase volume, every For a period of time to stop talking and let rest vocal cords, vocal cords moist water, so vocal in friction with each other when water lubrication to participate. In addition, Wan Fang Medical Center ENT physician Wu Jiazhe also mentioned that the right way voice is steady and slow abdominal breathing, so that the voice is more durable, more volume on average; emotional when they talk to relax, the pace Slow down, lower volume, increased lung capacity to take more exercise, adequate sleep and have so vocal rest, in dry conditions in less speech, drink plenty of water, do not drink coffee, too much ice, hot drinks and spicy food, so as not to stimulate the vocal cords , Resulting in inflammation. Treatment That is, early treatment can be hard to avoid knife Huang Hong Mengzhu Ren pointed out that the vocal cord polyps or long cocoon, it will allow in the vocal sound, because there are obstacles in the middle, do not shut down the lungs in a fixed volume, so that patients feel glottal leakage difficult to speak, must be more Great effort to maintain the same volume. However, at this time if immediate medical treatment to try to speak to the appropriate volume and more rest, is a cocoon disappear; but more light to the throat muscles to force the wrong way to raise the volume, with the passage of time, it will change the friction vocal drama, and Disruption of the vocal cords could not contact friction will be changed to make the voice hoarse, and the continued destruction of the end, only the last operation of a passer-by. Treatment, general practitioners will be as vocal cord polyps and the cocoon of long duration to determine ways to deal with, assuming that at the early course of disease, usually a simple drug, as well as the rest, and correct mistakes habits sound way to improve, if the situation so serious Polyps have looked mature, have very thick cocoon, we must, through micro-surgery to mitigate the problem. 2008-10-02 View more information, see the World Journal reported that e-ePaper.

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