Voice disorders

Overview

People may get a voice disorder for many reasons. A voice disorder, also called dysphonia, is a change in how the voice sounds. Voice disorders may include vocal cord paralysis, also called vocal fold paralysis; spasmodic dysphonia; issues with the voice box, also called the larynx; and vocal cord cysts, nodules, polyps or growths. Healthcare professionals trained in ear, nose and throat conditions and speech-language pathology diagnose and treat voice issues.

Voice disorder treatment depends on what's causing the voice change. Treatment can include:

• Voice rest.
• Voice therapy.
• Medicine.
• OnabotulinumtoxinA (Botox) injections.
• Surgery and other procedures.

Symptoms

Voice disorder symptoms can vary depending on the cause.

A hoarse voice can be an early sign of a voice disorder.

Other voice disorder symptoms can include:

• Voice tremors.
• Weakened or strained voice.
• Changes in voice pitch.
• Trouble speaking with a louder voice.
• Breathy or raspy voice.

When to see a doctor

If you have a hoarse voice or other voice issues for 2 to 4 four weeks, and you don’t have a cold or respiratory infection, talk with your healthcare professional and get an exam.

Causes

The cause of voice disorders, also called dysphonia, is vocal cords that can't work properly.

The voice box, also called the larynx, is made of a smooth covering called mucosa, with underlying muscle and cartilage. The voice box moves the vocal cords, also called the vocal folds. The voice box sits at the top of the windpipe, also called the trachea, and the base of the tongue. The vocal cords vibrate to make sound.

Air moving through the voice box causes the vocal cords to vibrate and brings them closer together. The vocal cords also help close the voice box during swallowing to stop you from breathing in food or liquid.

If vocal cords become swollen or damaged, form growths, or can't move as they should, they won't work properly. Any of these issues might cause a voice disorder. Swelling of the vocal cords also is known as inflammation.

There are many kinds of voice disorders. Examples of some common voice disorders are:

• Laryngitis. Laryngitis is a common voice issue that happens when the vocal cords become inflamed or irritated. This causes the voice to become hoarse. The condition can be short-lived, called acute, or long lasting, called chronic.
• Spasmodic dysphonia (spaz-MOD-ki dis-FOE-nee-uh). Spasmodic dysphonia is a long-term voice disorder that may be related to a brain and nervous system condition, also called a neurological condition. It causes the muscles of the voice box to tighten or spasm at various times. The condition can cause a strained voice.
• Polyps, nodules or cysts. These are growths that can appear on the vocal cords. These growths aren’t cancer.
• Precancerous and cancerous growths. These growths, called tumors, can appear on the vocal cords or voice box.
• Vocal cord paralysis or weakness. Vocal cord paralysis, also called vocal fold paralysis, is a condition that affects the muscles that control the voice. The nerve impulses to the voice box are interrupted. This causes one or both vocal cords, also called vocal folds, to be unable to move, called paralyzed. This can lead to voice and breathing issues.
• White patches, also called leukoplakia (loo-koh-PLAY-key-uh). Leukoplakia causes white patches on the tongue, vocal cords, gums, insides of the cheeks and bottom of the mouth.

Risk factors

Many factors can lead to a voice disorder, such as:

• Aging.
• Alcohol use.
• Allergies.
• Gastroesophageal reflux disease, also called GERD.
• Illnesses, such as colds or upper respiratory infections.
• Brain and nervous system conditions, also called neurological conditions. Examples are Parkinson's disease; stroke; dysphagia; essential tremor; amyotrophic lateral sclerosis, also called ALS; multiple sclerosis; and myasthenia gravis.
• Scarring or injury from neck surgery or from trauma to the front of the neck, chest or voice box that damages the vocal cords.
• Screaming.
• Smoking.
• Throat cancer. Throat cancer can form in the throat, also called the pharynx, or the voice box, also called the larynx.
• Throat dehydration.
• Thyroid issues.
• Voice misuse or overuse.