Voice disorders occur if one has issues with their tone, pitch, and volume. These complications come about if the vocal folds don’t vibrate/function normally. The vocal cords or vocal folds, are the two folds of flesh inside the voice box, also known as the larynx. When they function/vibrate properly, then voice is produced.
Causes of Voice Disorders
For normal speech, which means that the vocal cords are functioning normally, the two vocal folds need to vibrate together inside the voice box. If this doesn’t happen due to a number of reasons, then it is considered as a voice disorder. There are many causes of voice disorders, with the most common being:
- Cancerous and non-cancerous growths
- Swelling and inflammation
- Neurological voice disorders (spasmodic dysphonia)
- Benign Polyps, nodules or cysts on the vocal cords
- Precancerous and cancerous lesions
- Hormonal issues
- Vocal cord paralysis or weakness
- Nerve problems
- White patches (leukoplakia)
- Voice misuse
- Trauma to the larynx
Risk Factors of Voice Disorders
Although risk factors may not entirely cause voice disorders, they can however increase their chances of occurrence. These risk factors include:
- Throat dehydration
- Neurological disorders
- Upper respiratory infections
- Alcohol use
- Thyroid problems
- Gastroesophageal Reflux Disease (GERD)
Symptoms of Voice Disorders
Common symptoms of voice disorders, which can vary depending on whether one or both vocal folds are affected, include:
- Low- or high-pitched voice
- Pain in the throat
- Strained voice
- Hoarseness or loss of speech
- Noisy breathing
- Weak voice
- Feeling of a lump in the throat
Diagnosis of Voice Disorders
If you experience the above-mentioned symptoms, your primary care physician will refer you to an Ear, Nose and Throat specialist who will do evaluations based on your symptoms in order to arrive at a definitive diagnosis. The tests performed to diagnose voice disorders include:
This is the first test that is usually done by an ENT specialist. He/she uses a laryngoscope, which is a long flexible tube to look at the vocal folds. Additionally, he can do a videostrobolaryngoscopy, which uses a scope that has a light and camera attached on its tip, to look at the condition and position of the vocal cords. The images of the vocal codes are then reflected on a monitor.
Also known as L-EMG, the test measures the electric currents in the voice box muscles. To achieve this, small needles are inserted into the muscles of the larynx through the skin on the neck. During this procedure, the patient is asked to do a number of activities to activate the muscles. The L-EMG test is mainly used to determine how the recovery will be after treatment.
To help in determining the cause of the particular voice disorder, the ENT specialist may order other tests including X-ray, CT scans and MRI scans.
Treatment of Voice Disorders
Depending on the symptoms as well as the cause of a particular voice disorder, different treatment options may be recommended. These can range from surgery, voice therapy and bulk injections, or a combination of these treatments.
Depending on the cause of the voice disorder, voice therapy is usually recommended as the first form of treatment in order to improve their function. Usually this is done during the first year after the onset of symptoms before having surgery in order to restore nerve communication between the brain and the voice box.
If voice therapy does not help the recovery from the diagnosed voice disorder, then surgical options are recommended in order to improve the functions of the vocal folds. These surgical procedures include removal of benign, cancerous and pre-cancerous growths like polyps, tumors, cysts, nodules, respiratory papillomatosis, and leukoplakia.
If a certain voice disorder is a result of thyroid problems and hormonal imbalances, then certain hormonal therapy medications might be recommended.
Vocal Cord Injections
If the muscles in the vocal folds have weakened, then certain injections might be recommended. To make the folds bulkier, a substance such as body fat is injected in order to make them easier to move and vibrate against each other. If it’s a case of muscle spasms in the throat, then botulinum toxin, which is a muscle relaxer, might be injected.
To stop or reduce the symptoms of some voice disorders, some lifestyle changes might be recommended. These changes include:
- Staying hydrated
- Vocal cord exercises to relax the muscles
- Refraining from speaking loudly
- Regular resting of the voice if you use it regularly like singing
At King’s College Hospital Dubai, we focus on offering an exemplary service from initial consultation through to the final diagnosis and treatment and beyond. Our team of expert doctors and nurses are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re only a phone-call away.
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