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Voice disorders:Causes-Symptoms-Diagnosis-Treatment

What Are Voice Disorders?

Voice disorders affect your capability to talk usually. They may change the high-quality, pitch or loudness of your voice. A voice sickness can save you from speaking with others or expressing yourself. This may have a critical impact on your quality of lifestyles.

Your voice is the sound produced through vibration of your vocal folds, or vocal cords, within the larynx, also called your voice box. A voice disorder occurs whilst the vocal cords do not produce a clear sound.  Sometimes these conditions are known as disorders of the larynx or voice container disorders.

What Are Voice Disorders?
Voice Disorders

C.S. Mott Children’s Hospital offers comprehensive care for youngsters with voice disorders.  We provide a multidisciplinary technique to care, led by means of specialists in pediatric otolaryngology (ENT) and speech-language pathology.  Our program is designed to offer simply specialized care completely for kids - from providing an accurate diagnosis to developing individualized remedy plans for each infant and helping families every step of the way.

  1. Pharynx

  2. Larynx

Medical terms

  • If you have a voice disorder, you may experience problems with the pitch and volume of your voice. These problems can 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. That vibration is what produces speech.
  • Voice is the sound produced with the aid of vibration of the vocal folds (or vocal cords) within the larynx (voice field).
  • A voice disorder happens when the vocal folds do not vibrate properly enough to produce a clean sound.
  • People broaden voice issues for plenty of motives. Doctors who specialize in ear, nose and throat disorders and speech pathology professionals are worried about diagnosing and treating voice problems.
  • Treatment depends on what's inflicting your voice disorder, but may also encompass voice remedy, remedy, injections or surgical operation.
  • Voice disorders can impact the quality of life for anyone That is why it is important to see a physician at the first sign of a problem The vocal cords are two bands of muscle located in the larynx which is located near the base of the neck just above the breastbone The voice box contains the vocal cords and a number of other structures that help produce sound.
  • Voice disorders occur when the muscles and tissues in your mouth throat or nose are injured The injury can be caused by something as simple as yelling or straining your voice to more serious causes such as cancer Some of the more common symptoms of a voice disorder include: hoarseness (not being able to speak in a certain pitch) losing your voice suddenly after yelling or singing too much having a sore throat that doesn't go away a cough that lasts for more than two weeks without treatment coughing up blood or blood-stained mucus postnasal drip – a constant flow of watery mucus from your nose into your throat This is often.

Categories of Voice disorders

Examples of voice disorders include:

  • Laryngitis.  Laryngitis is when your vocal cords become enlarged. This makes your voice sound hoarse or you may not be able to speak at all. Acute laryngitis often happens suddenly as a result of a virus in the upper respiratory tract. It usually lasts just a few weeks. Treatment focuses on rest and drinking lots of fluids. Chronic laryngitis is when the swelling lasts for a long time. Common causes include a chronic cough that is due to asthma or GERD, and there is no specific treatment.

  • Vocal cord paresis or paralysis.  If one or both of your vocal cords are paralyzed, this can be caused by a virus, injury, surgery, or cancer. If the vocal cords are in a nearly closed position, you may have noisy speech. If someone is paralyzed in an open position, they may have a weak, breathy voice. Some people get better over time; in other cases the paralysis is permanent. Surgery or voice therapy may help improve the voice.

  • Spasmodic dysphonia.  This is a problem with the nerves that affects the voice. It can make the voice sound tight, quivery, hoarse, or moaning. Sometimes the person's voice may sound normal, and other times they may not be able to speak at all. Treatment may include speech therapy and injections of botulinum toxin to the vocal cords. The vocal cords are a set of thin, fine muscles that produce sound.

voice disorders in adults

There are many different types of voice problems including hoarseness, roughness , breathiness, weakness and strain. Each may be caused by a specific underlying problem in the vocal cords or voice box (larynx) by muscles that control the vocal cords or by nerves that provide sensation to the vocal cords.

voice disorders in children

Although speech disorders are often associated with childhood they can also occur in adults. Speech disorders can be caused by a variety of factors including physical and neurological problems, developmental disabilities, hearing impairment and psychological factors. If you suspect that your child has a speech disorder consult a physician immediately.

Is vocal cord paralysis curable?

Vocal cord paralysis is a condition where one or both vocal cords are not able to move. This results in the inability to produce voice which can lead to complications like breathing difficulties Surgery can treat vocal cord paralysis and restore normal function to the affected vocal cord(s).

How serious is vocal cord paralysis?

Vocal cord paralysis is a condition that occurs when the nerve impulses from the brain to the vocal cords are disrupted This can result in loss of voice whispering and breathiness Vocal cord paralysis may be temporary or permanent When it's temporary it's usually caused by a viral infection If the cause is nerve damage it's often caused by surgery or illness.

Symptoms Voice disorders

Symptoms of voice disorders range widely relying on their purpose.

If you have got a voice disorder, your voice may additionally:

  • rough vocal quality (raspy, audible aperiodicity in sound);

  • breathy vocal quality (audible air escape in the sound signal or bursts of breathiness);

  • strained vocal quality (increased effort; tense or harsh);

  • strangled vocal 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;

  • pulsed voice (fry register, audible creaks or pulses in sound);

  • shrill voice (high, piercing sound, as if stifling a scream); and

  • tremorous voice (shaky voice; rhythmic pitch and loudness undulations).

Other signs and symptoms include

  • 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.

You may have anxiety or ache in your throat even as speakme, or experience things like your voice container is tired. You may experience a "lump" for your throat whilst swallowing, or experience ache when you contact the out of doors of your throat.

Causes Voice disorders

For regular speech, your vocal cords want to touch collectively easily internal your larynx. Anything that interferes with vocal twine movement or touch can cause voice sickness. Many voice disorders may be cured with treatment whilst diagnosed early.

Your voice box (larynx) is manufactured from cartilage, muscle and mucous membranes located on the pinnacle of your windpipe (trachea) and the base of your tongue. Your vocal cords are two bendy bands of muscular tissues that sit down at the doorway of the windpipe. Sound is created while your vocal cords vibrate.

This vibration comes from air shifting via the larynx, bringing your vocal cords closer collectively. Your vocal cords also assist close your voice container whilst you swallow, preventing you from inhaling food or liquid.

If your vocal cords end up inflamed, increase growths or turn out to be paralyzed, they cannot work well, and you may develop a voice sickness.

Some common voice disorders include:

  • Laryngitis

  • Muscle tension dysphonia

  • Neurological voice disorders, such as spasmodic dysphonia

  • Polyps, nodules or cysts on the vocal cords (non cancerous lesions)

  • Precancerous and cancerous lesions

  • Vocal cord paralysis or weakness

  • White patches called leukoplakia

Possible causes can include:

  • Growths. In a few instances, more tissue might also shape on the vocal cords. This stops the cords from operating normally. The growths can consist of fluid-crammed sacs referred to as cysts, wart-like lumps called papilloma, or callus-like bumps known as nodules. There may be patches of damaged tissue known as lesions. Or regions of scar tissue. In some humans, a band of tissue called an internet can develop among the vocal cords. Other growths include a small region of continual inflammation (granuloma) and small blisters known as polyps. Growths will have many causes. These encompass illness, damage, most cancers, and vocal abuse.

  • Inflammation and swelling. Many matters can cause vocal wire infection and swelling. These encompass surgical operation, respiration illness or hypersensitive reactions, GERD, a few drugs, publicity to certain chemical compounds, smoking, alcohol abuse, and vocal abuse.

  • Nerve problems. Certain fitness situations can have an effect on the nerves that control the vocal cords. These can include a couple of sclerosis, myasthenia gravis, Parkinson ailment, Amyotrophic lateral sclerosis (ALS), and Huntington disease. Surgery or laryngitis can also damage nerves.

  • Hormones. Disorders affecting thyroid hormone, girl and male hormones, and increased hormones can cause voice problems.

  • Vocal abuse. The vocal cords can be careworn through the use of too much tension when speakme. This can motivate issues in the throat muscular tissues and affect the voice. Vocal abuse also can cause a voice disease. Vocal abuse is whatever that traces or harms the vocal cords. Examples include too much talking, shouting, or coughing. Smoking and continuously clearing the throat is also vocal abuse. Vocal abuse can motivate the vocal cords to get nodes and polyps. These change how the voice sounds. In a few instances, a vocal wire can wreck or burst from vocal abuse. This causes the twine to bleed (hemorrhage). You can lose your voice. Vocal twine bleeding ought to be handled right

Risk factors Voice disorders

Vocal cord dysfunction (VCD) is a voice disorder that causes hoarseness breathiness and weakness in the muscles that control the vocal cords While VCD isn't life threatening it can be serious enough to disrupt one's daily life and career The treatment of VCD is varied and may depend on several factors including the cause of the disorder and the person's age and overall health Speech therapy is often used as part of a treatment plan for VCD Medications may also be prescribed to treat symptoms of the disorder In some cases surgery may be recommended to help restore normal function to the vocal cords.

Many risk factors can contribute to a voice disorder, including:

  • Aging

  • Alcohol use

  • Allergies

  • Gastroesophageal reflux disease (GERD)

  • Illnesses, such as colds or upper respiratory infections

  • Improper throat clearing over a long time

  • Neurological disorders

  • Psychological stress

  • Scarring from neck surgery or from trauma to the front of the neck

  • Screaming

  • Smoking

  • Throat cancer

  • Throat dehydration

  • Thyroid problems

  • Voice misuse or overuse

Prevention Voice disorders

Some voice disorders aren’t preventable, but you may lessen your hazard through looking after your voice. Be certain to:

  • Avoid smoking, drugs and alcohol.

  • Drink plenty of water to keep your vocal cords hydrated.

  • Rest your voice frequently if you have an occupation that requires a lot of speaking.

Diagnosis Voice disorders

If you have a voice change that lasts for a few weeks, your healthcare provider may send you to see an ear, nose, and throat specialist (ENT). The ENT will ask you about your symptoms and how long they've been present. He or she may also examine you. Doctors will check your vocal cords and larynx using certain tests. These may include:

  • Laryngoscopy.  This way, the doctor can view the throat indirectly. With indirect laryngoscopy, the healthcare provider holds a mirror at the back of your throat and shines a light on it. With fiberoptic laryngoscopy, a thin lighted scope called a laryngoscope is used. The scope is put through your nose down into your throat and drinks directly from the bottle. Or pour the drink into a glass and drink it right away.

  • Laryngeal electromyography or EMG is a test that measures muscle activity in the larynx.This test measures the electrical activity in the muscles of the throat. A thin needle is inserted into some of the neck muscles while electrodes send signals to a computer. This can indicate nerve problems in the throat.

  • Stroboscopy. This test uses a strobe light and a video camera to see how the vocal cords are functioning during speech.

  • Imaging tests. An X-ray or MRI can show growths or other problems in the throat.

Your doctor will ask you special questions on your voice troubles and observe you thoroughly. A topical anesthetic can be applied to numb your vocal twine tissues earlier than your health practitioner examines them the use of one of the following tools:

  • Mirror. Your medical doctor inserts a long, rigid tool with an angled replicate, just like a dental replicate, into your mouth.

  • Flexible laryngoscope. Your physician inserts a flexible tube containing a mild and digital camera via your nose.

  • Rigid laryngoscope. Your doctor inserts a rigid viewing tube through your mouth.

  • Videostroboscopy. Your doctor inserts a digital camera that is mixed with a flashing light into your mouth to offer a slow-motion view of your vocal cords as they move.

Additional tests are sometimes used:

  • Sound (acoustic) analysis. Using laptop analysis, your health practitioner can measure irregularities inside the sound produced by using the vocal cords.

  • Laryngeal electromyography. Small needles are inserted via the skin to degree the electric currents on your voice container muscle mass.

Treatment Voice disorders

To treat a voice disorder, it depends on the cause. Treatment may include:

  • Lifestyle changes.  Some lifestyle changes may lessen or stop symptoms. These can include not yelling or speaking loudly and resting your voice regularly if you speak or sing a lot. Exercises to relax the vocal cords and surrounding muscles may help in some cases. Warm up your vocal cords before extensive periods of use. Drink lots of water. Stay hydrated so you can speak clearly.

  • Speech therapy. Working with a speech-language pathologist can help to remedy certain voice disorders. Therapy may include exercises and changes in speaking behaviors, such as using deep breaths to power vocalizations with adequate breathing.

  • Medicines. Some voice disorders can be treated with medicine. For example, antacid medication may be used to treat GERD (gastroesophageal reflux disease), hormone therapy may be used to treat problems with thyroid or female hormones.

  • Injections. Your doctor can treat throat spasms with injections of botulinum toxin. In some cases, your doctor may inject fat or other fillers into the vocal cords to help them close better.

  • Surgery. If cancer is the cause of the tissue growths, your doctor may be able to remove them with surgery. If radiation therapy is required, this will also be discussed with your doctor.

Depending on your diagnosis, your doctor will recommend one or more treatments:

  • Rest, liquids and voice therapy.Like some other part of the frame, the vocal cords need everyday rest and fluids. Speech pathology experts can teach you a way to use your voice more efficiently thru voice remedy, how to correctly clean your throat and what kind of liquid to drink.

  • Allergy treatments. If an allergy is developing an excessive amount of mucus on your throat, your health practitioner or an allergic reaction specialist can identify the hypersensitivity's purpose and offer a remedy.

  • Smoking cessation. If your voice trouble is the end result of smoking, quitting smoking can help improve your voice along with many different areas of your health, consisting of boosting your coronary heart fitness and lowering your chances of cancer.

  • Medications. Several medicinal drugs are available for treating voice problems. Depending on the motive of your voice sickness, you could want medicine to reduce infection, deal with gastroesophageal reflux or save you blood vessel regrowth. Medications may be taken orally, injected into the vocal cords or applied topically for the duration of surgical operation.


  • Removal of lesions. Non Cancerous lesions (polyps, nodules and cysts) on the vocal cords can also need to be surgically removed. Your health practitioner can cast off noncancerous, precancerous and cancerous lesions — such as recurrent breathing papillomatosis and white patches (leukoplakia) — using microsurgery, carbon dioxide laser surgical procedure and, whilst appropriate, the latest laser remedies, along with potassium titanyl phosphate (KTP) laser remedy.
    KTP laser remedy is a present day remedy that treats lesions at the vocal cords. It treats a lesion by cutting off the blood supply to the lesion, permitting the lesion to be removed whilst retaining the most quantity of underlying tissue.

  • Botox injections. Injections of tiny quantities of onabotulinumtoxinA (Botox) into the skin on your neck may be achieved in some instances. These injections can decrease muscle spasms or ordinary actions if you have a neurological movement sickness that impacts the vocal muscle groups of the larynx (spasmodic dysphonia).

Sometimes one vocal twine may additionally stop transferring (become paralyzed). If you have one paralyzed vocal cord, you would possibly often bitch of hoarseness. You may be choking whilst you drink beverages, however hardly ever have problem swallowing stable meals. Sometimes the trouble goes away with time.

If the problem persists, your physician may behave as one of numerous strategies. These strategies can push the paralyzed vocal cord toward the middle of the windpipe so that the vocal cords can meet and vibrate closer together. This improves the voice and allows the larynx to shut when you swallow.

Treatments include:

  • Bulk injection. Body fats, collagen, hyaluronic gel or some other accepted filler substance is injected, both through your mouth or the skin for your neck, to feature bulk to the paralyzed vocal cord or to deal with vocal cord weakness. The fabric fills the space next on your vocal wire and pushes it toward your other vocal cord, permitting them to vibrate greater intently collectively.

  • Thyroplasty. A small starting is created inside the cartilage from the outside of your voice field. The doctor inserts an implant via the hole and pushes it in opposition to the paralyzed vocal cord, moving it toward your different vocal twine.

  • Replacing the damaged nerve (reinnervation). In this method, a healthful nerve is moved from a specific place of your neck to update the damaged vocal twine. Your voice may enhance in six to 9 months. Some medical doctors combine this procedure with a bulk injection.

  • Voice disorders can be due to a variety of reasons and often interfere with normal speech.

  • An otolaryngologist should look for changes in your vocal quality.

  • There are many different ways to treat voice problems and each depends on the cause.

  • Do not shout or speak loudly for a long time, as this can damage your vocal cords.

  • Therapy is aimed at exercises that improve the function of the vocal cords and allow for adequate rest periods.

  • If you work with your voice a lot, it is important to keep it healthy for the long term.

  • Stay rested. Drink plenty of water. Use a microphone. Warm up your vocal cords. Don't smoke. Learn proper breath flow and seek care if there are any changes in the voice quality.

Next steps

Here are some tips for having a great visit to your healthcare provider:

  • Be prepared for your visit and what you hope to achieve.

  • Before your visit, make a list of questions you would like answered.

  • Make sure someone is with you when you ask questions and take notes so you don't forget what your provider tells you.

  • When you visit, make a list of the new diagnosis and any new treatments or tests. Also write down any new instructions your provider gives you.

  • Be aware of why a new medicine or treatment is being prescribed and how it will help you. Also be aware of any potential side effects.

  • Is there anything else you can try before considering treatment for your condition?

  • When recommending a test or procedure, be sure to know why it is being done and what the potential results could be.

  • If you don't take the medicine or have the test or procedure, there are likely to be consequences.

  • If you have a follow-up appointment, write down the date, time, and purpose of that visit on paper.

  • If you have any questions about your health care, be sure to contact your provider.

Voice disorders:Causes-Symptoms-Diagnosis-Treatment

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