Voice disorders, or dysphonia, are characterized by problems with pitch, loudness, and quality of the voice. They occur when the vocal folds are not vibrating normally in the larynx, or voice box. Voice disorders can occur from infections, colds and allergies, surgical procedures, excessive throat clearing, vocal misuse and abuse, or neurological disorders. People with dysphonia may demonstrate hoarse or breathy voice quality, loss of voice, painful or effortful speaking, tension in the neck muscles, chronic dry and scratchy throat, loss of voice, coughing or choking while eating, and reduced pitch range.
Voice disorders include vocal cord nodules and polyps, vocal cord paralysis, paradoxical vocal fold movement, and spasmodic dysphonia.
- Vocal cord nodules are callouses that develop over time from vocal abuse and can become harder and larger gradually.
- Vocal cord polyps are blisters that develop from vocal abuse and misuse and are typically larger than nodules.
- Vocal cord paralysis occurs when the vocal folds are unable to move, which can cause voice, breathing, and swallowing problems.
- Paradoxical vocal fold movement occurs when there is abnormal vocal fold movement, such as the vocal folds closing when they should be open.
- Spasmodic dysphonia is a chronic voice disorder in which vocal fold movement is forced and strained due to involuntary movements of laryngeal muscles.
Treatment depends on the cause and severity of the voice disorder. A medical evaluation by an otolaryngologist (ENT) is recommended to identify the cause to the voice disorder. The ENT will typically perform an endoscopic evaluation by inserting an endoscope into the mouth or nose to look at the larynx and the movement of the vocal folds. Voice disorders are best treated when diagnosed early. Speech-language pathologists can help patients with voice disorders by eliminating vocal abusive behaviors, practicing relaxation techniques, teaching good vocal hygiene, finding optimal positioning, and improving pitch, loudness, and breath support. Severe cases may require surgical intervention if treatment is unsuccessful.