Patient: Hello doctor, I am from Shantou, Guangdong, I used to be an English teacher, because there were many classes and I taught graduation class, so after 6 years of teaching, I gradually felt pain in my throat and had difficulty in speaking, I thought it was a common occupational disease, I didn’t care about it, and continued to teach for two years, in the last year of 06, the class has developed into a very painful and difficult to speak, I had to bring water into the classroom while drinking water in order to speak. After the end of the semester, I took sick leave and sought medical help everywhere, and now I have taken a break for 3 years. give medicine, neither of which worked. Now I am really running to any hospital, doctors are saying that it is fine, just prescribe a little oral liquid and anti-inflammatory drugs, but it is not useful to me at all, I am now in a sad mood to the extreme, please doctor you save me, help me identify the cause, save my life, I am grateful, thank you! Yang Haidi, Department of Otolaryngology, Second Affiliated Hospital of Sun Yat-sen University: The medical history you provided is not very detailed. Is there any change in your usual speaking voice? Is there any hoarseness? Is there any other joint pain? Is there any frequent acid reflux? Any other joint pain? Are there any nodules or polyps on fiberoptic examination? Is there any redness or swelling of the vocal cords? Based on your medical history and occupational characteristics, I think it may be vocal cord nodules, but if there is frequent acid reflux, gas, etc., you should consider whether there is gastropharyngeal reflux, because many patients with gastropharyngeal reflux can also have similar symptoms, such as other joint pain, and if there is joint pain in the fingers and other joints, you should be careful about the laryngeal cartilage joints, etc. If you can provide a more detailed medical history for further evaluation.