Voice Disorders – Causes, Symptoms and Treatment

Voice Disorders Types, Causes | Voice disorder specialist | Voice Disorders treatment

Voice Disorders definition: When air comes out of the lungs and passes over the vocal cords – it makes a sound called a voice. It is produced when vocal cords vibrate normally. When the quality of your voice is good, you will not have any problem, but when the quality of your voice – the tone, volume and pitch changes or becomes problematic, you will have a voice disorder. The problems with your voice may be due to several reasons.

Classification of voice disorders

There are several classification systems pertaining to voice disorders. In general, they are categorized as

Structural: voice disorders resulting from structural changes – such as changes in larynx, vocal cords.

Organic: These are due to physiological changes in vocal cords, larynx and respiratory mechanisms.

Neurogenic: these are due to problems with the nervous system.

Functional: These are due to inefficient or improper use of the vocal mechanism.

Kaufman in 1982 proposed a classification system for functional voice disorders. According to the classification, voice disorders are classified as vocal abuse syndrome, inappropriate falsetto, habituated hoarseness, aphonia, dysphonia, relapsing aphonia, post-operative dysphonia. Among these types, vocal abuse syndrome is the major one and the other comes under muscle tension dysphonia (MTD).

Muscle tension dysphonia is an umbrella term – under which psychogenic, habituated and compensatory types of voice disorders fall.

Voice Disorders in Adults: They are common in adults – especially in the female adult population. This means voice disorders are prevalent in the adult population. Chronic laryngitis is common in both male and female adults. Prevalence has been reported to be higher in elderly adults with certain professional background.

Voice Disorders in Children: In children, the prevalence of voice disorders is lower when compared to adults.

Voice Disorders symptoms

The symptoms associated with voice disorders include loss of voice, hypo nasal or hypernasal resonance, loudness, abnormal pitch, strangled voice, roughness, breathiness in voice, wet sounding voice, weak voice, pulsed voice, shrill voice, hoarse voice, voice breaks, frequent coughing and throat cleaning and excessive tenderness, pain or laryngeal tension. Any of these signs and symptoms can occur in unison or isolation.

Causes of Voice Disorders

Organic neurologic and functional causes of voice disorders

Structural causes include muscle atrophy associated with ageing (sarcopenia), recurrent respiratory papilloma, glottal stenosis, vocal nodules. These are vocal fold abnormalities

Laryngopharyngeal reflux and laryngitis cause inflammation of the larynx. Trauma due to chemical exposure, intubation or external blow to the front of the neck (external trauma).

Neurologic causes include multiple sclerosis, Parkinson’s disease, spasmodic dysphonia and recurrent laryngeal nerve paralysis.

Functional causes include overuse of vocal cords (vocal fatigue), excessive throat clearing, screaming, yelling (phono trauma), muscle tension dysphonia and ventricular phonation

Psychogenic causes: Conversion Aphonia and dysphonia, chronic stress, anxiety and depression also cause voice disorders

Voice Disorders types

Your voice box (larynx) sits at the top of the windpipe (trachea) and the base of the tongue. It is made of cartilage, muscle and mucous membrane. When the vocal cord in the voice box vibrates, the sound is created.

When the air moves through the voice box, vibrations develop and bring the vocal cords closer together. Vocal cords also help in preventing you from inhaling liquid or food by closing your voice box. When something goes wrong with your vocal cords – such as when they become weak (paralyzed), get inflamed and develop growth, they cannot work properly and lead to a voice disorder.

Some of the Common voice disorders include:

• Vocal cord weakness (paralysis)
• Precancerous and cancerous lesions
• Non-cancerous lesions
• Nodules or cysts on the vocal cord
• Muscle tension dysphonia
• Laryngitis
• Leukoplakia (White patches)
• Spasmodic dysphonia (Neurological Voice Disorders)

Risk factors for voice disorders

There are many factors that contribute to voice disorders, such as

• Screaming
• Smoking
• Psychological stress
• Neurological disorders
• Throat irritation due to improper clearing
• Upper respiratory tract infections
• Common cold and flu infections
• Voice misuse or overuse
• Thyroid problems
• Throat dehydration
• Throat cancer
• Neck trauma (front of the neck)
• Gastroesophageal reflux disease (GERD)
• Allergies
• Alcohol use
• Ageing

Diagnosis of Voice Disorders

Your ENT specialist asks you about the symptoms and the voice issues that you have been suffering from. The doctor performs a comprehensive examination of your throat by using a mirror similar to a dental mirror or a rigid or flexible laryngoscope with a light and camera attached to it. Another instrument is a video stroboscope with a flashing light for a better view of your vocal cords can also be used for a slow-motion view of the vocal cords.

ENT doctors may perform sound (acoustic) analysis by using a computer and also laryngeal electromyography based on the requirement.

What kind of doctors treat voice problems?

Physicians who have specialization and expertise in the diagnosis and treatment of ear, nose and throat conditions and who specialize in speech pathology treat voice disorders.

Treatment for voice disorders mostly depends on the cause and the symptoms associated with the condition – and it mainly includes medication, therapy, injections or surgery.

How to treat voice disorders?

Voice Disorders Treatment

Dr Neetu Modgil will recommend one or more treatments, depending on your diagnosis:

Voice therapy, rest and liquids: Speech pathologist with their experience and expertise train their patients in using voice more efficiently and properly. They also teach how to clear the throat and the amount of liquid to drink. Vocal cords may get exhausted by regular stress. They need rest, fluids and therapy.

If excess mucus is the cause of the allergy, then the doctor will provide treatment for the allergy. Similarly, if smoking is the cause of the disturbance in the voice, smoking cessation therapy helps in improving the condition.

There are different types of medications available for the treatment of voice disorders. Based on the cause, any experienced ENT specialist will prescribe them to prevent acid reflux, reduce inflammation and prevent blood vessel regrowth. Medication is available in all forms – oral, topical and injectables.

Removal of lesion

Cysts, nodules and polyps are non-cancerous lesions on vocal cords. Doctors remove them surgically. Similarly, ENT doctors also remove all types of precancerous, cancerous and non-cancerous lesions – leukoplakia, papillomatosis using microsurgery and newer methods of treatments – such as laser treatment and laser surgeries.

Botox injection – If vocal cord disorders have a neurological cause, then ENT doctors give Botox injections (onabotulinumtoxinA) on the neck. This procedure is helpful in reducing abnormal movements and muscle spasms of the vocal muscles (spasmodic dysphonia) owing to a neurological disorder.

For the treatment of a paralysed vocal cord (the one that has stopped moving), ENT doctors push the affected vocal cord to the middle of the windpipe to help both the cords vibrate closer and work efficiently. They will use any of these procedures – thyroplasty, bulk injection and replacement of the damaged nerve.

Meet Dr Neetu Modgil for the best Voice Disorders Treatment in Hyderabad.