? The vocal cords are flexible mucosal folds equipped with muscles and fibrous ligaments. Vibrations due to air expelled from the lungs produce phonation.The most common symptoms of vocal cord changes include: dysphonia, pain, hoarseness, huskiness, raspy voice, and lowering of voice pitch, all of which can interfere with communication and, thus, with social interactions.? Voice disorders are often due to overuse of the vocal cords or, more rarely, to mucosal lesions provoked by inflammation, infection, polyps, nodules and nerve damage.? Toxic substances such as smoke, alcohol and inhaled gases can damage the vocal cords.? Medications can also damage the vocal cords through various mechanisms, including mucosal deposits, mucosal dryness, inadequate vocal cord lubrication, changes in saliva composition, mucosal oedema, erythema, necrosis or haematomas, and vocal cord paralysis? The drugs implicated mainly consist of inhaled corticosteroids, antimuscarinics, sympathomimetics, androgens, antihypertensive drugs, NSAIDs, antithrombotics and anticoagulants, neuroleptics, and anti-VEGF agents.? Patients exposed to a drug known to affect the vocal cords should be warned of this risk, especially when the damage may be irreversible (androgens) or the patient is highly dependent on their voice. A dmg-related cause should be considered when a patient presents with symptoms of vocal cord damage.
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