Voice Disorders

Voice problems, also called voice disorders, happen to people for various reasons. A voice disorder is simply a change in how your voice sounds – maybe it's raspy, hoarse, or you can't speak as loudly as usual.

Doctors who specialize in ear, nose, and throat (ENT) issues, and speech therapists (sometimes called speech-language pathologists) are the professionals who can figure out what's wrong and how to fix it.

Fixing a voice problem depends entirely on what's causing it. Different treatments are available. This might include exercises to improve your voice (voice therapy), medicine, injections, or, in some cases, surgery.

The larynx, or voice box, is a part of your throat made of soft tissue, muscles, and a lining. It's located at the top of the windpipe (trachea) and sits just above the base of your tongue. Your voice is created when your vocal cords vibrate.

When you breathe, air flows through the voice box. This air makes the vocal cords vibrate, and they can move closer together. The vocal cords are also important because they help close off the voice box when you swallow. This prevents food or liquids from going into your lungs.

Problems with the vocal cords can cause voice disorders. For example, if the vocal cords are swollen, inflamed, have growths on them, or can't move correctly, they won't work properly, leading to a voice problem.

Several conditions can affect your voice:

• Spasmodic dysphonia: This happens when the nerves controlling the vocal cords don't work correctly, causing the voice to sound strained or have sudden breaks.

• Non-cancerous growths: Sometimes, growths like polyps, nodules, or cysts develop on the vocal cords. These growths aren't cancerous.

• Precancerous and cancerous growths: Less often, growths on the vocal cords can be precancerous or cancerous. These need to be checked by a doctor.

• White patches (leukoplakia): White patches on the vocal cords can sometimes be a sign of a precancerous condition. It's important to have these checked by a healthcare professional.

It's crucial to remember that any changes in your voice should be evaluated by a doctor. Early diagnosis and treatment are important for managing voice disorders.

Voice problems can have many causes. Some common reasons include:

• Getting older: As we age, our vocal cords can change, making it harder to produce clear sounds.

• Alcohol use: Drinking too much alcohol can irritate the vocal cords and lead to problems speaking. This irritation can make your voice hoarse or raspy.

• Brain and nervous system issues: Conditions like Parkinson's disease or a stroke can affect the nerves controlling your voice, making it difficult to speak clearly. These conditions can cause weakness or tremor in the muscles used for speaking.

• Illnesses: Colds, the flu, and other upper respiratory infections can inflame the vocal cords, leading to a temporary loss of voice or hoarseness. Other illnesses can also impact your voice in various ways.

• Neck surgery or injuries: Scarring from surgery on the neck or injuries to the front of the neck can sometimes affect the vocal cords' ability to vibrate correctly.

• Excessive yelling or screaming: Pushing your voice too hard, like during extended shouting or screaming, can strain your vocal cords and cause damage.

• Smoking: Smoking irritates the vocal cords and can lead to chronic hoarseness and other voice problems. The smoke and chemicals in cigarettes can inflame and damage the delicate tissues of the voice box.

• Dehydration of the throat: Not drinking enough fluids can dry out the throat, making it harder to speak and leading to a scratchy voice. Proper hydration is essential for maintaining a healthy voice.

• Thyroid problems: Issues with the thyroid gland can sometimes affect the vocal cords, causing voice changes.

• Misusing or overusing your voice: Talking too much, yelling for extended periods, or singing too loudly can strain your vocal cords and cause problems like hoarseness or even permanent damage. This is especially true if you don't take breaks and allow your vocal cords time to rest.

To diagnose voice problems, your doctor will first ask about your symptoms and conduct a physical examination. Before the exam, they might give you a medicine to numb the area. They may use various tools to see what's happening inside your throat:

• A mirror: Your doctor might use a long, angled mirror similar to a dentist's mirror, inserted into your mouth to get a good view.

• A flexible tube with a light and camera (flexible laryngoscope): This thin, bendable tube is inserted through your nose. It has a small light and camera, allowing your doctor to see your vocal cords clearly.

• A stiff tube with a light and camera (rigid laryngoscope): This tube is inserted through your mouth. It's helpful for getting a detailed view of the vocal cords, but it might feel slightly more uncomfortable.

• A camera with a flashing light (videostroboscope): This tool uses a camera combined with a flashing light to show your vocal cords in slow motion as they vibrate. This helps your doctor see how well they're working.

Your doctor might also use other tests to get a complete picture of the problem:

• Sound analysis: A computer analyzes the sound your voice makes. This can help identify any unusual patterns or characteristics in your voice that could be a sign of a problem.

• Voice box muscle test (laryngeal electromyography): Very thin needles are inserted through your skin and into the muscles of your voice box. These needles measure the electrical activity in the muscles, providing information about how they are working. This test is used to pinpoint muscle issues that may be causing the voice problem.