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Voice Disorders

Voice Disorders

What is a Voice Disorder?

Any condition that affects the performance of the voice-producing organ – the larynx – can cause a voice disorder. Usually, hoarseness is the main symptom, but laryngeal disorders can cause other, more subtle problems.

Common Symptoms of Laryngeal Disorders

  • Hoarseness or breathiness of the voice
  • Voice breaks
  • Limitations in pitch range
  • Limitations in volume and projection
  • Difficulty making oneself understood over background noise
  • Voice ‘fatigue,’ or discomfort and deterioration of the voice with prolonged use
  • Breathlessness while talking
  • Chronic throat clearing or coughing
  • Difficulty breathing or swallowing

A wide variety of conditions can cause laryngeal dysfunction. A more complete description of each of these can be found by selecting the diagnosis of interest at left.

Any hoarseness that persists beyond two weeks, especially in a smoker, should be evaluated by a physician who can inspect the vocal cords.

Voice disorders can be highly subjective: that is, what may be a serious problem for one person may present little difficulty to another. Some of this has to do with a given person’s expectations, but a key factor is vocal demand. Simply put, vocal demand describes the vocal requirements of a given person’s daily life. Clearly, a singer or an actor will have different vocal demands from a teacher or a trial attorney, who in turn will have different vocal demands from someone who does most of his or her work on a computer keyboard, or someone who cares for a hearing-impaired individual.

There is no established way to quantify vocal demand. Generally, though, the longer and the louder one must voice throughout the day, the greater the vocal demand, and the more likely small irregularities in laryngeal function are to be troublesome. Also, different types of voicing – for instance, professional vocal performance – have lower tolerance for subtle changes in voice quality than others.

The professions most commonly evaluated for voice disorders are performing artists, teachers, attorneys, salespeople and other customer service personnel.

Because voice quality is subjective and vocal demands vary, the person with the disorder is usually the best judge of the severity and importance of the problem (assuming it is non-cancerous), and whether it justifies a proposed treatment.

In benign voice disorders, the role of the physician is to make an accurate diagnosis, and explain what options are available, including discussions of expected outcome and attendant risks. Needless to say, a physician who is fully informed of both your symptoms and of your vocal needs is best equipped to offer advice tailored to your problem.

Ultimately, a treatment decision, and especially the decision for surgery, should be made together with your physician, taking into account your vocal behaviors and vocal demands.

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