Voice Disorders
What are Voice Disorders?

Voice disorders can result from a number of different underlying causes. Some patients have problems with only their voice while other patients have difficulty with both voice and swallowing.

A common reason for a hoarse voice is swelling of the vocal cords and can be caused by a number of factors. Excessive use of the voice or misuse of the voice are common factors in creating this swelling. Acid reflux from the stomach is also a common cause. Acid causes irritation to the throat and voice box and can cause intermittent or constant hoarseness.

Hoarseness can also be caused by abnormalities of the muscles that move the vocal cords. In some patients, the muscles controlling the vocal cords contract too vigorously and can cause disorders known as spastic dysphonia. Chronic muscle tension can also be a cause of hoarseness. A change in vocal cord function caused by benign or cancerous growths can occur leading to alterations in the voice and sometimes swallowing.

The evaluation of a patient with a voice disorder should begin with a visit to an ear, nose, and throat physician. A careful history and a physical examination, including the voice box, will often reveal the diagnosis.

In some cases, the abnormalities of function of the voice box are not obvious on routine examination. In some situations, the physician may request that video stroboscopy be performed. Video stroboscopy uses the video and digital imaging technology to examine the voice box during the production of voice. The physicians of Missouri Ear, Nose and Throat Center have this technology available to evaluate our patients. This study gives high resolution video images of the voice box in slow motion so that the vocal cords may each be carefully studied. The procedure is done in the office with the aid of a mild topical anesthetic. An exam can be completed in a few minutes and is well tolerated by even our younger patients.

The treatment of voice disorders ranges from speech therapy to medical therapy to surgical therapy. Our physicians will help you to determine the best treatment choice for your problem.

Surgical therapy may consist of removal of an abnormal growth or scar tissue on the voice box. This is most often performed under anesthesia in the operating room. Some procedures require more extensive surgery with an open incision and include thyroplasty. This operation is offered to patients who have a paralyzed vocal cord on one side. The surgeon repositions the paralyzed vocal cord to facilitate better function and improved voice quality.

Medical therapy for voice disorders most commonly includes treatment for acid reflux. Dietary modification may be necessary along with a medication used to reduce the production of acid. Positional therapy is recommended to elevate the head at night to further reduce the tendency of acid entering the throat while sleeping. Medical therapy may also include treating of other causes such as chronic cough due to some other problem like bronchitis or a medication.

Speech therapy is used very commonly with many of the voice disorders. In some cases, speech therapy is the only therapy that is required. Speech therapy may be appropriate for patients with vocal nodules, vocal polyps, vocal cord paralysis, spastic dysphonia, and vocal misuse or overuse. A speech therapy assessment consists of: Oral-facial structure and function, muscular tension sites, maximum sustained phonation, pitch, Intensity, and quality.

The physicians at Missouri Ear, Nose, and Throat Center are here to help with your voice concerns. Make an appointment today.

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