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Voice Disorders

Overview

People develop voice disorders for many reasons. An ENT (ear, nose, throat) specialist is involved in diagnosing and treating these Voice disorders. 

What are voice disorders?

Your voice box (larynx) consists of cartilage, muscle and mucous membranes located at the top of your windpipe and the at your toungue’s base. The vocal cords are two flexible bands of muscle tissue that are located at the entrance of the windpipe. The sound is created due to the vibration of the vocal chords. The vibration comes from the air moving through your larynx, bringing the vocal cords closer together. 

Voice disorders occur when your vocal cords do not vibrate normally. If you experience problems with tone, volume, pitch, or other qualities, the chances are that you may have a voice disorder.

What are different types of voice disorders?

The different types of voice disorders include the following:

  1. Laryngitis

Laryngitis is a voice disorder that causes your vocal cords to swell. It may make your voice hoarse or affect your ability to speak properly. 

Usually, acute laryngitis occurs suddenly. The primary cause is considered to be a virus in the upper respiratory tract. In most cases, it goes away in a few weeks. The standard treatment procedure for acute laryngitis includes resting your voice and drinking plenty of fluids.

In chronic laryngitis, the swelling of the vocal cords lasts for a longer time. The causes include GERD, chronic cough, or using inhalers for asthma. The treatment options depend on what causes chronic laryngitis.

  1. Spasmodic dysphonia

Spasmodic dysphonia is a type of voice disorder that occurs due to a nerve issue that makes your vocal cords spasm. You may experience a hoarse, jerky, tight, quivery, or groaning voice. Sometimes, your voice may sound normal, while other times you may not be able to speak at all. Treatment options include injections of botulinum toxin to your vocal cords or speech therapy.

  1. Vocal cord paresis or paralysis

In this voice disorder, you may experience partial paralysis (paresis) or complete paralysis of your vocal cords. The common causes of vocal cord paralysis include cancer, stroke, nerve injury during surgery, or a viral infection that affects your vocal cords.

If one or both of your vocal cords get paralyzed in an almost closed position, you may experience difficulty breathing. If your vocal cords are paralyzed in an open position, you may experience a husky  and weak voice. 

In some cases of vocal cord paralysis, the patients get better with time. Whereas in other cases, the paralysis may be permanent. The doctor may recommend voice therapy and surgery to help improve the voice.

What are the symptoms of voice disorders?

If you develop a voice disorder, you may experience one or more of the following:

  • A strained or choppy voice
  • A hoarse voice
  • An unusual change in your pitch
  • A quivering sound
  • A breathy, whispery, or weak voice

You may even experience pain in your throat while speaking or feel like your vocal cords are tired. You may even feel pain while touching your throat or the presence of a lump in your throat while swallowing.

When to see a doctor

If you experience unusual changes in your throat or voice for a prolonged time, visit a doctor. Many voice disorders can be treated if diagnosed early.

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What causes voice disorders?

In a normal speech, your vocal cords typically touch each other smoothly inside of your larynx. Anything that interferes with the movement of your vocal cords can cause voice disorders. 

The possible causes of voice disorders include the following:

  • Growth of a tissue

Sometimes, extra tissue forms on your vocal cords, which interferes with your vocal cords and stops them from working normally. 

Such growths can include callus-like bumps called nodules, wart-like lumps called papilloma, or fluid-filled sacs called cysts. 

  • Swelling and inflammation

Several factors are known to cause swelling or inflammation in your vocal cords. Some of these are respiratory illnesses or allergies, excessive consumption of alcohol or smoking, exposure to certain chemicals, and surgery.

  • Nerve problems

Some medical conditions can affect the nerves that control your vocal cords. Some of these conditions are Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), myasthenia gravis, and Huntington’s disease.

How are voice disorders diagnosed?

If you experience the symptoms of voice disorders for a longer time, your doctor may refer you to an ENT specialist. They will ask you questions about your medical history and examine your throat. 

The ENT specialist may also perform some tests to confirm the diagnosis, these include:

  • Laryngoscopy

This test allows the doctor to view your throat. They will use a tiny mirror at the back of your throat and examine it with the help of a flash. 

In the case of a fiberoptic laryngoscopy, a thin scope with a light called a laryngoscope is used. The doctor may insert it through your nose and into your throat or directly onto your throat.

  • Stroboscopy

For this test, the doctor will use a strobe light and video camera to check the vibration in your vocal cords during speech.

  • Laryngeal electromyography

Laryngeal electromyography measures the electric activity in your throat muscles. The doctor will place a thin needle into some of the muscles in your neck. At the same time, electrodes will send signals from your muscles to the computer. This test will help determine the nerve problems that may be causing your voice disorder.

  • Imaging tests

Imaging tests such as a CT scan or X-ray may be used to detect any abnormal growth or other tissue problems in your throat.

How are voice disorders treated?

The doctor may prescribe one or more treatment options depending on your diagnosis.

The standard treatment options include:

  • Voice therapy, rest, and liquid intake

In mild cases of voice disorders, the doctor may recommend that you rest your vocal cords and drink plenty of fluids. Speech pathology specialists can help you with voice therapy and teach you how to use your voice effectively.

  • Medications

Depending on the causes of your voice disorders, the doctor may prescribe medications to treat gastroesophageal reflux, reduce inflammation, or prevent blood vessel regrowth. 

  • Allergy treatment

If a particular allergy creates too much mucus in your throat, the doctor may refer you to a specialist for the diagnosis and treatment of the allergy.

  • Injections

If you have muscle spasms in your throat, the doctor may give you an injection of botulinum toxin. The doctor may even give you an injection of fat or other fillers to help your vocal cords close better.

  • Surgery

In cases of abnormal tissue growth around the vocal cords, the doctor may recommend surgery. If the tissue growth is cancerous, the doctor may recommend cancer treatments such as radiation therapy.

Conclusion

Many reasons can cause voice disorders. The treatment options usually depend on the causes and symptoms of voice disorders. Your doctor may be able to diagnose, find out the causes, and recommend a treatment option for a speedy recovery.

Frequently Asked Questions (FAQs)

What are organic voice disorders?

Neurogenic organic voice disorders (NOVD) refer to your larynx’s vocal functioning mechanism. These are caused due to spasmodic dysphonia, vocal tremors, or paralysis of vocal folds.

What causes a raspy voice in children?

Many things can cause your child’s voice to become raspy, rough, or hard to understand. Some of the causes include breathing dry air, cold or sinus infection, talking or yelling too loudly, or exposure to pollution.

Is vocal cord dysfunction dangerous?

In vocal cord dysfunction (VCD), your vocal cords do not open completely. As a result of this, you may face difficulty breathing. However, vocal cord dysfunction is treatable.

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The content is medically reviewed and verified by experienced and skilled ENT (Ear Nose Throat) Specialists for clinical accuracy.

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