Voice Disorders

A problem with pitch, volume, tone, and other qualities of your voice which usually occur when your vocal cords don't vibrate normally is defined as a voice disorder.
Voice is the sound produced by humans using the lungs and the vocal folds in the larynx or voice box. Vocal cords are 2 folds of tissue inside the voice box (larynx). The vibration of those cords is what makes a speech.

Voice disorders include:

Laryngitis: This is when your vocal cords swell. It makes the voice sound hoarse or you may not be able to speak at all. Acute laryngitis happens suddenly. It is often caused by a virus or bacteria in the upper respiratory tract. It often lasts just a few weeks. Treatment is to rest the voice(speak less) and drink plenty of fluids. Chronic laryngitis is defined as the swelling of the vocal cords for a long time. Common causes include a chronic cough, using inhalers for asthma, and Acid reflux (gastroesophageal reflux disease). Treatment of chronic laryngitis depends on its cause.

Vocal cord paresis or paralysis: The vocal cords can be partly or fully paralyzed. This can be caused by a viral infection that affects vocal cord nerves, an injury to a nerve during surgery, stroke, or cancer. If both of your vocal cords are paralyzed in a nearly closed position, you may have noisy or difficult breathing. If one vocal cord is paralyzed in an open position, you may have a weak, breathy voice. Some people will get better over time. In other cases, the paralysis is permanent. Appropriate voice therapy may help the voice in some cases. There are surgeries which can help recover the voice quality if therapy doesn’t help.

Spasmodic dysphonia: It is a disorder that causes the vocal cords to spasm. It can make the voice sound tight, hoarse, or groaning. At times, the voice may sound normal. Other times, the person may not be able to speak. Assessment by a voice specialist helps in diagnosis. Speech therapy may be tried, but often shots (injections) of botulinum toxin to the vocal cords are the solution to this problem.

What causes voice disorders?

For normal speech, the vocal cords need to touch together smoothly inside the larynx. Anything that interferes with vocal cord movement can cause a voice disorder. Many voice disorders can be treated when diagnosed early.

Voice disorders can be caused by many factors such as :

Growths: In some cases, extra tissue may form on the vocal cords which can stop the cords from working normally. The growths can include cysts (fluid-filled sacs), papilloma (wart-like lumps), or nodules (callus-like bumps). There may be patches of damaged tissue called lesions or areas of scar tissue. In some people, the web (a band of tissue) can grow between the vocal cords. Other growths include a small area of chronic inflammation (granuloma) and small blisters called polyps. Growths can have many causes. These include illness, injury, cancer, but the most important and common cause is vocal abuse(overuse or improper use of voice).

Inflammation and swelling: Many things can cause vocal cord inflammation and swelling such as surgery, respiratory illness or allergies, GERD, some medicines, exposure to certain chemicals, smoking, alcohol abuse, and vocal abuse.

Nerve problems: Multiple sclerosis, myasthenia gravis, Parkinson disease, Amyotrophic lateral sclerosis (ALS), and Huntington disease can affect the nerves that control the vocal cords. Certain neck surgeries can also harm nerves.

Hormones: There are certain disorders which affect thyroid hormone, female and male hormones, and growth hormones which can cause voice disorders.

Vocal abuse: The vocal cords can be stressed when you speak using high pitch and it can cause problems in the throat muscles and affect the voice or cause a voice disorder. Vocal abuse is anything that harms the vocal cords such as too much talking, shouting, or coughing. Smoking and constantly clearing the throat is also vocal abuse. Vocal abuse can cause the vocal cords to get nodes and polyps or cysts. These change how the voice sounds. In some cases, a vocal cord can break or burst from vocal abuse and can lead to haemorrhage (cord bleeding). You can lose your voice. Vocal cord bleeding should be treated properly.

What are the symptoms of a voice disorder?

Symptoms of a voice disorder include:

Have a quivering sound
Harsh sound
Strained or choppy sound
Be weak, whispery, or breathy
Having a high pitch or low pitch

You may have pain in your throat while speaking, or feel like you are not able to speak. You may feel a lump in your throat when having food. Or you may feel pain when you touch the outside of your throat.

How are voice disorders diagnosed?

If you feel the change in voice then consult an ENT - ear, nose, and throat specialist (otolaryngologist). The doctor will ask you about the symptoms and how long you've had them. The ENT doctor will check your vocal cords and larynx using certain tests. These may include:

Laryngoscopy: This lets the doctor check your throat from inside. With indirect laryngoscopy, the ENT specialist holds a small mirror at the back of the throat and shines a light on it. With fibre-optic laryngoscopy, a thin, lighted scope (laryngoscope) is used.
Laryngeal EMG (electromyography): It measures electrical activity in the throat muscles. A thin needle is put into some of the neck muscles. At the same time, electrodes send signals from the muscles to a computer. This can show nerve problems in the throat.
Stroboscopy: This test uses a strobe light and a video camera and a microphone to see the pattern of vibrations of the vocals cords as we speak
Imaging tests: X-rays and MRI can show growths or other tissue problems in the throat.
Sakra World hospital has the best ENT doctor in Bangalore providing the best care and treatment you need.

How are voice disorders treated?
Treatment for a voice disorder depends on its causes. Treatment may include:

Lifestyle changes: These changes may help reduce or stop symptoms.

Not yelling or speaking loudly. And resting your voice often if you speak or sing a lot.

Exercises to relax the vocal cords and muscles around them can help in some cases.

Warm up the vocal cords before long periods of speaking.

Drink fluids to stay hydrated.

Speech therapy: Working with a speech-language pathologist can help with certain voice disorders. Therapy may include exercises and changes in speaking behaviours. Some of these may include timing deep breaths so that they power your speech with adequate breathing.
Medicines: Some voice disorders are caused by a problem that can be treated with medicine. For example, antacid medicine may be used for GERD or hormone therapy may be used for problems with thyroid or female hormones.
Injections: Your doctor can treat muscle spasms in the throat with a shot of botulinum toxin. In some cases, your doctor can inject fat or other fillers into the vocal cords. This can help them close better.
Surgery: ENT doctor in Bangalore can remove some tissue growths. If cancer causes growth, you may need other treatment. This may include radiation therapy.
Consult the best ENT specialist in Bangalore if you have any concern regarding your voice.