Overview
Voice disorders refer to changes in the quality, pitch, or sound of a person's voice. These changes can be caused by various factors, including problems with the vocal cords, nerve or muscle disorders, or other medical conditions. Voice disorders can affect anyone, but they are more common in older adults and people who use their voices extensively, such as teachers, singers, or actors. Treatment options for voice disorders depend on the underlying cause and may include voice therapy, medications, injections, or surgery.
Understanding the disease
Symptoms
Symptoms of voice disorders may include:
- Changes in voice quality, pitch, or volume
- Hoarseness or roughness in the sound of the voice
- Breathiness or airiness in the voice
- Weakness or strain in the voice
- A voice that sounds nasal or congested
- A voice that cracks or breaks during speaking
- Increased fatigue or effort when speaking
- Difficulty projecting the voice
- A voice that sounds monotonous or dull
- A voice that sounds too high or too low. These symptoms may vary depending on the underlying cause of the voice disorder. It is important to consult a healthcare provider trained in ear, nose, and throat conditions or a speech-language pathologist for an accurate diagnosis and appropriate treatment.
Risk Factors
Risk factors for developing voice disorders include:
- Aging
- Alcohol use
- Allergies
- Conditions related to the brain and nervous system, such as Parkinson's disease or a stroke
- Gastroesophageal reflux disease (GERD)
- Illnesses, such as colds or upper respiratory infections
- 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
Development
Voice disorders develop due to issues with the vocal cords, such as swelling, inflammation, growths, paralysis, or weakness. Some common voice disorders include laryngitis, spasmodic dysphonia, polyps or nodules on the vocal cords, precancerous and cancerous growths, vocal cord paralysis or weakness, and white patches (leukoplakia). Factors that contribute to voice disorders include aging, alcohol use, allergies, brain and nervous system conditions, gastroesophageal reflux disease (GERD), illnesses, neck surgery or trauma, screaming, smoking, throat cancer, throat dehydration, thyroid problems, and voice misuse or overuse.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect voice disorders, especially if the symptoms persist or worsen over time. If you experience any of the following, it is advisable to consult a healthcare provider trained in ear, nose, and throat illnesses or a speech-language pathologist:
- A change in the quality, pitch, or volume of your voice that lasts for an extended period.
- Difficulty speaking, hoarseness, or vocal fatigue that does not improve with rest.
- Pain or discomfort when speaking or swallowing.
- Unexplained weight loss.
- A family history of throat cancer or other voice disorder-related conditions. Remember that voice disorders can have various causes, and a healthcare provider will help determine the underlying issue and recommend appropriate treatment options.
Diagnosis
To diagnose voice disorders, a healthcare provider will typically ask about the voice problems and conduct an examination. They may use tools such as a mirror, flexible laryngoscope, rigid laryngoscope, or videostroboscope to examine the vocal cords. Additional tests might include sound analysis or laryngeal electromyography. In the case of childhood apraxia of speech (CAS), a speech-language pathologist will assess the child's speech sounds, words, phrases, language skills, and muscle function. A diagnosis of CAS is based on the pattern of speech problems observed, and various tests may be conducted depending on the child's age and ability to cooperate.
Management and Treatment
Treatment
Treatments for voice disorders depend on the underlying cause. Voice therapy, drugs, shots, or surgery may be recommended by healthcare providers trained in ear, nose, and throat illnesses and speech-language pathologists. Some common voice disorders include laryngitis, spasmodic dysphonia, polyps, nodules or cysts on the vocal cords, precancerous and cancerous growths, vocal cord paralysis or weakness, and white patches. Risk factors for voice disorders include aging, alcohol use, allergies, conditions related to the brain and nervous system, gastroesophageal reflux disease (GERD), illnesses, scarring from neck surgery or trauma, smoking, throat cancer, throat dehydration, thyroid problems, and voice misuse or overuse.
Preparing for medical consultation
To prepare for an appointment for voice disorders, it is important to:
- Note down any symptoms your child or you are experiencing, including any that may seem unrelated to voice disorders.
- Bring a list of all medicines, vitamins, or supplements that the affected individual is taking.
- Write down questions to ask the healthcare provider or speech-language pathologist, such as:
- Does the individual have a voice disorder, and if so, what type?
- How is the voice disorder different from other speech or language problems?
- Will the condition improve, and if so, how?
- What treatments are available, and which are recommended?
- Are there any lifestyle changes or restrictions that should be followed?
- Could any medications be causing the voice disorder or exacerbating it?
- Be aware of any pre-appointment restrictions, such as avoiding heavy meals or vocal strain before the appointment.
- Prepare a list of questions to ask during the appointment, including basic questions like the probable cause, the likely duration of the condition, and the best course of treatment.
- Consider bringing a family member or friend along to help with communication and to remember the information received during the appointment. Remember to prioritize open communication with the healthcare provider and speech-language pathologist to ensure the best possible care for the voice disorder.