Voice Disorders, part I

View Part II.

Voice disorders range widely in their vocal impairment, severity, causes and treatments. Causes can vary from trauma, inflammation or structural changes to immunological, neurological or behavioral factors that result in less-than-ideal voice production.

Some conditions heal on their own, but others require voice therapy and medical management. Nerve damage, acid reflux, smoking, an over- or under-active thyroid, stress and a person’s psychiatric and physical health can all create or worsen a voice disorder. Some voice disorders are caused simply by vocal misuse, like speaking or singing with poor technique, and overuse, such as excessive singing, talking, coughing or yelling.

The tissue of the vocal folds, or vocal cords, sometimes become swollen or injured due to illness, heavy use, exposure to irritants, etc. Sometimes the muscles of the larynx, or voice box, do not work properly due to nerve damage, behavior patterns, or other problems. Common disorders include the development of growths such as nodules or polyps, swelling as in laryngitis, laryngopharyngeal reflux and vocal cord paralysis. 

Laryngitis–inflammation of the vocal cords.
Symptoms: Raspy, hoarse voice. May be low- or high-pitched, depending on how the vocal cords are affected in terms of mass and mobility.
Causes: Excessive use of voice, infections, inhaled irritants, acute laryngopharyngeal reflux.

Vocal Nodules or Nodes–small, callous-like benign growths on vocal cords, which usually occur in pairs and can be a problem for professional voice users. Typically can be reduced or eliminated with proper voice care.
Symptoms: Hoarse, low and breathy voice. Vocal fatigue.
Causes: Vocal misuse and overuse.  Also, dehydration, smoking, drinking alcohol, certain medications, drug use,  laryngopharygeal reflux and environmental factors can precipitate and aggravate the condition. 

Vocal Polyps–soft, blister-like benign growth on a vocal cord, which usually occur unilaterally (on one vocal cord).
Symptoms: Hoarse, low and breathy voice. Vocal fatigue. Severity depends on location and size of lesion.
Causes: As with vocal fold nodules, polyps are associated with heavy voice use, and may be precipitated or aggravated by dehydration, environmental factors, hormones, medications, drug use and allergies.

Vocal Cord Paresis or Paralysis–weakness or immobility of one or both vocal folds causing them to not open or close properly. Cases range from relatively mild to life threatening as paralysis can allow food or liquid to enter the lungs. May require therapy or surgery, although no action may be necessary.
Symptoms: Depending on the exact location of the insult and the position of the immobile vocal fold, the voice may be weak and breathy; there can be stridor during inhalation; and swallowing and coughing can be difficult.
Causes: Mechanical trauma (e.g., head/neck/chest surgery or injury), tumor, certain disease processes, viral infections, hereditary neoplasms and idiopathic.

Voice therapy involves collaborating with your laryngologist (one can be recommended), identifying your vocal demands and habits, and working with you to develop a way of speaking that is optimal for you. The goal is a voice that has endurance and meets your needs.

Posted on: 9 April 2009 | Category: General, Voice


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