Voice Disorders
Conditions affecting the pitch, loudness, quality, or resonance of the voice.
Voice disorders occur when the quality, pitch, loudness, or resonance of the voice differs from what is expected for an individual's age, gender, or cultural background, and causes concern for the speaker or listener. Voice disorders can result from vocal fold pathology (such as nodules, polyps, cysts, or paralysis), muscle tension patterns, neurological conditions, respiratory disease, laryngopharyngeal reflux, or habitual vocal misuse and overuse.
Common voice disorders include vocal fold nodules (often seen in children and professional voice users), vocal fold paralysis or paresis, muscle tension dysphonia, spasmodic dysphonia, paradoxical vocal fold movement, and presbyphonia (age-related voice changes). Individuals with voice disorders may experience hoarseness, breathiness, vocal fatigue, pitch breaks, reduced loudness, throat pain or discomfort, and effortful voicing.
Speech-language pathologists specializing in voice disorders work closely with otolaryngologists (ENTs) to diagnose and treat voice conditions. Voice therapy may include vocal hygiene education, resonant voice therapy, vocal function exercises, semi-occluded vocal tract exercises, laryngeal massage, and strategies for optimal voice use. For many voice disorders, behavioral voice therapy is the first-line treatment and can be highly effective.
Signs & Symptoms
- •Persistent hoarseness, breathiness, or rough vocal quality
- •Vocal fatigue or voice that deteriorates with use throughout the day
- •Loss of vocal range, pitch breaks, or difficulty projecting
- •Throat pain, tightness, or discomfort during speaking
- •Strained or effortful voice production
- •Frequent throat clearing or coughing
Treatment Approaches
- •Vocal hygiene education and behavioral modification counseling
- •Resonant voice therapy and semi-occluded vocal tract exercises
- •Vocal function exercises to improve vocal fold flexibility and stamina
- •Laryngeal massage and manual circumlaryngeal therapy for muscle tension
- •Collaboration with ENT for medical or surgical management when indicated
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