Typically, we take our voices for granted and never give much thought to how the vocal folds produce voice. Voice disorders are more common than people realize. Approximately 28 million workers in the U.S. experience daily voice problems. Many of them are teachers, sales personnel, clergy, singers, fitness instructors, coaches, or people who speak often in noisy environments.
Most voice disorders are caused by misuse of the voice
talking too loudly
talking too much on one breath
speaking with effort from the throat
straining your voice
chronic throat clearing
Other voice disorders result from a virus or an unrelated surgical procedure. Certain medical conditions (i.e. reflux, allergies, asthma, effects of certain medications) and lifestyle habits (i.e. smoking, alcohol, soda, caffeine, insufficient hydration) can also effect the voice.
Warning signs you might have a voice disorder:
Hoarseness, raspiness, or strain on a daily, weekly, or otherwise frequent basis
Voice sounds deeper (lower)
Needing to repeat, especially in background noise
Others ask “what’s wrong with your voice?”
Speaking becomes an effort
Voice worsens as the day goes on
Uncomfortable feeling/strain in the throat when at work, home, socially, or in the community
Straining to sing higher notes
“Laryngitis” lingering well after a cold/upper respiratory infection has passed
A voice problem that lasts longer than 2-3 weeks.
One of the most common voice complaints. Is most often caused by benign conditions such as a cold, sore throat, or vocal over use. It usually goes away on it's own. If it persists for several weeks it may represent a more serious problem that requires medical and therapeutic attention
Vocal fold nodules
Typically caused by vocal abuse such as loud, excessive talking or screaming. This results in a hoarse voice that may fatigue easily. The nodules (bumps) are considered benign and when identified early, respond well to voice therapy treatment
Vocal misuse and abuse
Results in a voice that is hoarse, scratchy, and gets tired easily. There may be soreness and tightness in the throat. The voice may be better in the morning, but fades out during the day when demands for speaking arise and there may be periods of voice loss. Misuse can result from using the wrong speaking patterns when communicating. These inappropriate patterns can include:
the wrong pitch level
too much tightness in the throat
poor breath patterns for voice
lack of variability in pitch
excessive talking during illness
adopting an inefficient "professional voice"
excessive loud talking
excessive throat clearing/coughing
Irritable larynx syndrome and chronic cough
This is a group of symptoms, often associated with acid reflux or an illness (i.e. cold or flu). The illness goes away but the cough doesn't. Sometimes the coughing can be severe and persistent, occurring many times in the day and often in response to a specific triggering event. Symptoms include:
cough for more than 2-3 weeks and the absence of an illness
dry scratchy throat
post nasal drip
lump in throat
Can be caused by vocal abuse or laryngeal refluxing. Results in a hoarse voice, periods of occasional voice loss, and feeling of excessive voice fatigue during periods of sustained talking
Occur initially as small bumps on the vocal folds. Cysts are a fluid collection in a sac-like structure. The voice will be hoarse and often at a lower pitch. Over the time the cysts can grow larger causing increased stiffness of the vocal fold and increasing voice problems.
Vocal fold paralysis
Failure of one vocal fold to move, resulting in a very breathy voice. Can be accompanied by swallowing difficulties. May be seen after strokes, injury, or a nerve disorder
A disease in which malignant (cancer) cells form in the tissues of the larynx. Use of tobacco products and drinking too much alcohol can affect the risk of laryngeal cancer. Signs and symptoms include a sore throat, hoarse, rough voice, and ear pain.
Struggle and strain to talk, the voice may sound tense, squeezed and sound like it rapidly stops and starts. May have uncontrolled changes in pitch and loudness
Characterized by heartburn. Caused by the acidic contents of the stomach coming back up into the esophagus, however many people who reflux don't have any symptoms of heartburn. Results in a chronic hoarse voice, symptoms of laryngitis, frequent throat clearing and cough, and a sensation of a lump in the throat. Chronic reflux can lead to polyps developing on the vocal folds from constant irritation
Vocal fold bowing
Abnormal pattern of vocal fold movement when the vocal folds only partially come together to produce voice. The cause is often due to muscle atrophy (poor muscle tone, loss of strength).
Paradoxical vocal fold movement or vocal cord dysfunction
May be misidentified as an athletic attack (although may be seen in patients with asthma). Results in stridor during breathing, caused by abnormal vocal fold movement. Difficulty breathing, wheezing, shortness of breath and throat muscle tightness.