What are voice disorders?
may have a voice disorder if you have a problem with pitch, volume, tone, and other
qualities of your voice. These problems occur when your vocal cords don't vibrate
voice is the sound that air makes when it is forced out of your lungs and passes over
your vocal cords. Vocal cords are the 2 folds of tissue inside your voice box (larynx).
The vibration of those cords is what makes speech.
Voice disorders include:
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 in the upper respiratory tract. It often lasts just a few weeks.
Treatment is to rest the voice and drink plenty of fluids. Chronic laryngitis is when
the swelling lasts for a long time. Common causes include a chronic cough, using
inhalers for asthma, and GERD (gastroesophageal reflux disease). Treatment of chronic
laryngitis depends on the cause.
Vocal cord paresis or paralysis.The vocal cords can be paralyzed or partly paralyzed (paresis). This can be
caused by a viral infection that affects your vocal cord nerves, an injury to a nerve
during surgery, stroke, or cancer. If one or both of your vocal cords are paralyzed
in a nearly closed position, you may have noisy or difficult breathing. If they are
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. Surgery and voice
therapy may help improve the voice.
dysphonia. This is a nerve problem that causes the vocal cords to spasm. It
can make the voice sound tight, quivery, jerky, hoarse, or groaning. At times, the
voice may sound normal. Other times, the person may not be able to speak. Treatment
may include speech therapy and shots (injections) of botulinum toxin to the vocal
What causes voice
normal speech, your vocal cords need to touch together smoothly inside your larynx.
Anything that interferes with vocal cord movement or contact can cause a voice disorder.
Many voice disorders can be cured with treatment when diagnosed early.
disorders can be caused by many factors. In some cases, the cause is not known. Possible
causes can include:
In some cases, extra tissue may form on the vocal cords. This stops the cords
from working normally. The growths can include fluid-filled sacs called cysts,
wart-like lumps called papilloma, or callus-like bumps called nodules. There may be
patches of damaged tissue called lesions. Or areas of scar tissue. In some people, a
band of tissue called a web 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, and vocal
Inflammation and swelling. Many things can cause vocal cord inflammation and
swelling. These include surgery, respiratory illness or allergies, GERD, some
medicines, exposure to certain chemicals, smoking, alcohol abuse, and vocal
problems. Certain health conditions can affect the nerves that control the
vocal cords. These can include multiple sclerosis, myasthenia gravis, Parkinson
disease, Amyotrophic lateral sclerosis (ALS), and Huntington disease. Surgery or
laryngitis can also harm nerves.
Disorders affecting thyroid hormone, female and male hormones, and growth
hormones can cause voice disorders.
abuse. The vocal cords can be stressed by using too much tension when
speaking. This can cause problems in the throat muscles and affect the voice. Vocal
abuse can also cause a voice disorder. Vocal abuse is anything that strains or harms
the vocal cords. Examples include 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. These change how the voice sounds. In some
cases, a vocal cord can break or burst from vocal abuse. This causes the cord to
bleed (hemorrhage). You can lose your voice. Vocal cord bleeding must be treated
What are the symptoms of a voice
you have a voice disorder, your voice may:
rough or harsh (hoarseness)
strained or choppy
whispery, or breathy
high or low or change in pitch
may have tension or pain in your throat while speaking, or feel like your voice box is
tired. You may feel a lump in your throat when swallowing. Or you may feel pain when
you touch the outside of your throat.
How are voice disorders
you have a voice change that lasts for a few weeks, your healthcare provider may send
you to see an ear, nose, and throat specialist (otolaryngologist). This doctor will ask
you about your symptoms and how long you've had them. He or she may check your vocal
cords and your larynx using certain tests. These may include:
Laryngoscopy. This lets the doctor view the throat. With indirect
laryngoscopy, the healthcare provider holds a small mirror at the back of the throat
and shines a light on it. With fiber-optic laryngoscopy, a thin, lighted scope
(laryngoscope) is used. The scope is put through your nose down into your throat. Or
it is put directly down into your throat.
EMG (electromyography). This test 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.
This test uses a strobe light and a video camera to see how the vocal cords are
vibrating during speech.
tests. X-rays and MRI can show growths or other tissue problems in the
How are voice disorders
Treatment for a voice disorder depends on what's causing it. Treatment may include:
changes. Some of these changes may help reduce or stop symptoms. They can
include 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
therapy. Working with a speech-language pathologist can help with certain
voice disorders. Therapy may include exercises and changes in speaking behaviors.
Some of these may include timing deep breaths so that they power your speech with
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 the thyroid or female hormones.
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.
Your doctor can remove some tissue growths. If cancer causes the growths, you
may need other treatment. This may include radiation therapy.
Key points about voice
disorders affect the ability to speak normally.
These disorders can include laryngitis, paralyzed vocal cords,
and a nerve problem that causes the vocal cords to spasm.
voice may quiver, be hoarse, or sound strained or choppy. You may have pain or a lump
in your throat when speaking.
Your healthcare provider may send you to see an ear, nose, and
throat specialist (otolaryngologist). This doctor may do certain tests including
Treatment for a voice disorder depends on what's causing it. Treatment may include
lifestyle changes, speech therapy, medicine, injections, and surgery.
to help you get the most from a visit to your healthcare provider:
the reason for your visit and what you want to happen.
your visit, write down questions you want answered.
someone with you to help you ask questions and remember what your provider tells
visit, write down the name of a new diagnosis, and any new medicines, treatments, or
tests. Also write down any new instructions your provider gives you.
why a new medicine or treatment is prescribed, and how it will help you. Also know
what the side effects are.
your condition can be treated in other ways.
why a test or procedure is recommended and what the results could mean.
what to expect if you do not take the medicine or have the test or procedure.
have a follow-up appointment, write down the date, time, and purpose for that
you can contact your provider if you have questions.
Online Medical Reviewer:
Ashutosh Kacker MD
Online Medical Reviewer:
Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer:
Wanda Taylor RN PhD
Date Last Reviewed:
© 2000-2018 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.