COMMON VOICE DISORDERS

People with voice disorders have very typical complaints, which include:

Hoarseness
Scratchy voice, weak voice, breathy voice
Difficulty with loudness, increased effort to talk
Pain or discomfort while speaking or singing
Change in singing voice
Vocal fatigue (worsening voice quality or discomfort with voice use)
Change in voice quality following trauma or surgery to the neck, throat, or larynx.
Change in pitch of the voice (puberphonia, andrpohonia)
Hyper and hyponasality
Frequent throat clearing

What are the causes of voice disorders?

Voice disorders can be caused by a variety of factors, including:

Excessive and improper use of the voice by voice professionals
Bad habits such as smoking or other forms of tobacco abuse and alcohol consumption
Allergies

Environmental pollution

General disorders like hypothyroidism, diabetes etc.
Other factors like infections, tumors, neck surgery and trauma.
Hyperacidity

As a result of these factors, various pathological lesions and conditions may arise in the vocal cord region, thus causing a voice disorder. These can be lesions such as vocal nodules, polyps, cysts, granulomas, cancer, papilloma and such conditions as vocal fold paralysis, vocal cord edema (swelling) and muscle tension dysphonia.

Factors such as resonance disorders also affect the quality of the voice. These include hypernasality (too much sound through the nose) and hyponasality (too little sound through the nose).

Hypernasality is most common in children who have a cleft palate or repaired cleft palate but can have other causes as well.

Hyponasality is most often caused by a narrow nasal passage or narrowing of the area connecting the nose and the mouth.

How is a voice disorder diagnosed?

A thorough evaluation of the patient is required to diagnose the patient's problem and to decide its management. A typical evaluation normally includes:

1 A thorough history taking, to look into the cause and nature of the complaints 2 Assessing the condition of ear nose and throat with clinical examination 3 Examining the vocal cords using a specialized flickering light source, called digital videostroboscopy. This allows an assessment of the movement and vibration of the vocal cords. 4 Analysis of the sound signal (acoustic analysis) 5 Analysis of airflow and air pressure during voice production (aerodynamic assessment) 6 Evaluation of muscle tone in the muscles used to produce voice (electromyography) 7 Evaluation of the nasal cavity, palatal region, nasopharynx and oropharynx are carried out with the help of a flexible fibreoptic nasopharyngoscope.

Other special tests may also be required for a complete evaluation of the voice disorder. Many times a voice problem has to be diagnosed and treated in conjunction with other specialists such as a chest physician, gastroenterologist, endocrinologist, neurophysician and psychologist.

Treatment:

After the patient's voice disorder has been diagnosed, various treatment options are offered to the patient by the voice surgeon and the voice therapist. These might include medicines,voice therapy or surgery.