What are voice disorders?

You may have a voice disorder if you have a problem with pitch, volume, tone, and other qualities of your voice. These problems occur when your vocal cords don’t vibrate normally. Your voice is the sound that air makes when it is forced out of your lungs and passes over your vocal cords.

Dysphonia is a term used to describe the auditory-perceptual symptoms of voice disorders. Dysphonia is characterized by altered vocal quality, pitch, loudness, or vocal effort.

How common are voice disorders?

There are many types of voice disorders. Among adults (aged between 19 and 60 years) with a voice disorder, the most frequent diagnoses included functional dysphonia (20.5%), acid laryngitis (12.5%), and vocal polyps (12%). 

What are the causes of voice disorders?

Some common voice disorders include:

  • Laryngitis
  • Neurological voice disorders (spasmodic dysphonia)
  • Polyps, nodules or cysts on the vocal cords (noncancerous lesions)
  • Precancerous and cancerous lesions
  • Vocal cord paralysis or weakness
  • White patches (leukoplakia)

There are many items that can contribute to voice disorders such as:

  • Aging
  • Alcohol use
  • Allergies
  • Colds or upper respiratory infections
  • Improper throat clearing over a long time
  • Neurological disorders
  • Psychological stress
  • Screaming
  • Smoking
  • Throat cancer
  • Throat dehydration
  • Thyroid problems
  • Voice misuse or overuse

Signs and symptoms of voice disorders

Signs and symptoms of dysphonia include:

  • roughness (perception of aberrant vocal fold vibration);
  • breathiness (perception of audible air escape in the sound signal or bursts of breathiness);
  • strained quality (perception of increased effort; tense or harsh as if talking and lifting at the same time);
  • strangled quality (as if talking with breath held);
  • abnormal pitch (too high, too low, pitch breaks, decreased pitch range);
  • abnormal loudness/volume (too high, too low, decreased range, unsteady volume);
  • abnormal resonance (hypernasal, hyponasal, cul de sac resonance);
  • aphonia (loss of voice);
  • phonation breaks;
  • asthenia (weak voice);
  • gurgly/wet sounding voice;
  • hoarse voice (raspy, audible irregularity in sound);
  • pulsed voice (fry register, audible creaks or pulses in sound);
  • shrill voice (high, piercing sound, as if stifling a scream); and
  • tremulous voice (shaky voice; rhythmic pitch and loudness undulations)
  • increased vocal effort associated with speaking;
  • decreased vocal endurance or onset of fatigue with prolonged voice use;
  • variable vocal quality throughout the day or during speaking;
  • running out of breath quickly;
  • frequent coughing or throat clearing (may worsen with increased voice use); and
  • excessive throat or laryngeal tension/pain/tenderness.

Note that these may occur singularly or in combination with one another. Over time and even during treatment, others may emerge.

The severity of voice disorders can vary in individuals depending on the type and severity of disorder and cannot always be determined by listening alone (i.e. auditorily). In certain cases, referrals may be needed for additional help in determining the cause of a particular issue.

Treatment for voice disorders

Again, diagnosis may require expert advice from various specialists and may require one or more of the following treatments:

  • Lifestyle changes
  • Speech therapy
  • Medicines
  • Injections
  • Surgery

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