Voice Disorder - Symptoms, Diagnosis and Treatment

An approach to treating voice disorder

Dr.Satish Chandra profile Authored by Dr.Satish Chandra on 24 Dec 2013 - 18:06.

One of the most common health related problems seen these days among professional voice users like teachers, counselors, singers, call center personnel, receptionists, help desk personnel and sales executives, is a disordered voice. Voice disorder is a medical condition affecting the production of speech.
 

A disordered voice can be defined as one that reflects the following characteristics:

·         Change in one’s basic voice

·         Inaudible, unclear or unstable voice

·         Inappropriate voice for gender and age

·         Unable to speak for longer duration

·         Associated with discomfort and pain while speaking
 

Hoarseness is the term often used by patients to describe changes in their voice quality, but a voice which is perceived as rough, harsh or breathy in quality is defined as hoarse voice.
 

Many reasons lead to injury of vocal cords or voice problems. Some of them are:

·         Excessive usage of voice without proper hydration

·         Infection of the voice box, upper airway

o    Laryngitis

o    Laryngotracheobronchitis

o    Tuberculosis

·         Screaming

·         Acid peptic disease (gastritis)

·         Smoking

·         Growth on the vocal fold (structures which produce voice)

o    Vocal nodules

o    Vocal polyps

o    Reinke’s edema

·         Paralysis of voice box

·         Trauma

·         Lung disorders

·         Nasal polyps

·         Cancer of larynx, esophagus, throat, lung, thyroid, ear, nose

·         Brain stroke

·         Neurological disorders

The symptoms of voice disorder that patients normally complain are:
 

·         Change in voice quality (hoarseness, roughness and breathiness )

·         Pitch that is increased or decreased which is not appropriate for their age and sex

·         Inability to control their voice as required (pitch breaks , voice cutting out )

·         Inability to raise the voice

·         Voice that tires with use

·         Difficulties or restrictions in the use of voice at different times of the day or to specific tasks

·         Difficulty in singing

·         Reduced ability to communicate effectively

·         Throat related symptoms (soreness, discomfort, aching, and dryness) related to voice use.

·         Emotional, psychological effects caused by the above.

 

Patient evaluation:

Any patient with change in voice persisting for more than two weeks requires evaluation with a specialist, particularly with a history of tobacco use.

The causes of this, ranges from simple infection to aggressive malignancy (cancer).

Investigations:

·         Get Endoscopic examination of the larynx

·         Get radiological investigations like chest X-Ray, CTscan or MRI scan if required                   depending on the endoscopy findings.

Most patients with a voice disorder benefit from advice on vocal hygiene, hydration, steam inhalation, lifestyle and dietary modifications.
 

Timely consultation of speech specialist may be useful. Conditions like vocal cord growth may require surgical intervention (micro laryngeal surgery) to confirm the nature of disease and for permanent treatment.
 

Early stage cancers if diagnosed early can be treated completely without losing voice. Even the patients with paralysis can be treated with Thyroplasty procedures.
 

Dr. Satishchandra, ENT, Head and Neck Surgery Specialist, advises one to take care of their voice by not overusing, screaming, maintaining adequate hydration (saliva in the oral cavity), avoiding habits like smoking and alcohol, and maintaining regular diet habits. Consulting a specialist if voice problems persist is important for timely and effective treatment.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.