Dr David Lowinger MBBS FRACS Ear Nose & Throat Specialist Surgeon
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Adults

Voice Problems

Voice is the sound produced when the air passes from the lungs to the larynx or voice box. During speaking the vocal cords close partially as the air passes through them and create vibrations and produces sound. Each person's voice is as unique as fingerprint.

Several disease conditions or damage to body parts associated with voice may cause various voice problems such as pain or discomfort during speaking, trouble in controlling the pitch, loudness or quality of voice. Voice disorders include vocal cord nodules and polyps, vocal cord paralysis, paradoxical vocal fold movement and spasmodic dysphonia.

  • Vocal cord nodules and polyps: Vocal cord nodules are noncancerous growths occurring on both the vocal cords and are caused due to overuse of the vocal cords.. Vocal cord polyps are abnormal growth appearing as a swelling or nodule on either one or both of the vocal cords.

  • Vocal cord paralysis: Vocal cord paralysis occurs when one or both the vocal cords do not open or close properly causing voice problems and difficulty in swallowing and breathing.

  • Paradoxical vocal fold movement: Paradoxical vocal fold movement refers to vocal cord dysfunction where the vocal cords do not act normally. In case of paradoxical vocal fold movement, the vocal cords close instead of opening when breathing.

  • Spasmodic dysphonia: It is a chronic voice disorder caused by forced or strained movements of the vocal cords causing abnormal changes in the voice.

Causes of voice problems

Injury to the vocal cords causes voice problems. Teachers, singers, preachers, smokers, person with throat cancer and aged people are at high risk of developing voice problems. People who talk too much or scream are also at risk of having voice problems. Loss of voice can also result from common cold, allergies, bronchitis and exposure to certain irritants.

Symptoms

Individuals with voice problems may have harsh voice, hoarseness or abnormal changes in the voice, difficulty in breathing or swallowing, coughing and a feeling of a lump in the throat.

Diagnosis

Your doctor will diagnose your voice problem with a medical history, and by performing a physical examination. Additional tests may be done to determine vocal cord vibration and to know the exact cause of your voice problem.

Treatment

In most cases resting the vocal cords may be necessary. The goal of the treatment is to regain the normal voice. For chronic voice problems medicines, surgery, voice therapy or combination of these may be needed. Voice therapy teaches how to use the voice correctly by using different techniques.

Surgery may be recommended to remove the nodule and polyp from the vocal cord. Muscle-nerve transplantation and medialization thyroplasty are the two surgical options for vocal cord paralysis. Medialization thyroplasty brings the paralyzed vocal cord towards midline.

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Royal Australasian College of Surgeons The Australian Society Of Otolaryngology Head And Neck Surgery Australian New Zealand Society of Paediatric Otorhinolaryngology (ANZSPO) The University of New South Wales The University of Sydney Harvard Medical School

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