Voice Dysfunction – Adults

Have you ever had “laryngitis” that just won’t go away? Or heard someone on the radio or TV with a “hoarse” or “gravelly” voice?

These are examples of voice disorders, which are becoming more common. They often start as mild symptoms, like a hoarse voice, but if left untreated, they can worsen and even lead to complete voice loss. Voice disorders can be caused by various factors, including nodules, polyps, cancer, acid reflux, weak or paralyzed vocal cords, excess tension in the vocal box, or overuse/misuse of the voice.

Certain professions, such as teaching, ministry, telemarketing, law, singing, and coaching, can put individuals at a higher risk due to the constant strain on their vocal cords.

Types of Voice Dynfunction

Voice dysfunction can arise from a variety of conditions that affect the vocal cords and surrounding structures. Below are some common types of voice disorders that we treat:

Vocal Nodules

Vocal nodules are small, benign growths that develop on the vocal cords due to prolonged vocal strain or misuse. They often form in pairs and can cause hoarseness, breathiness, and vocal fatigue. This condition is frequently seen in individuals who use their voices extensively, such as singers, teachers, and public speakers.

Vocal Polyps

Vocal polyps are soft, fluid-filled lesions that can appear on one or both vocal cords. They are typically caused by acute vocal trauma, such as excessive shouting or prolonged voice overuse. Symptoms may include hoarseness, a rough or breathy voice, and a sensation of something being stuck in the throat. Unlike nodules, polyps are usually larger and may require medical or surgical intervention.

Muscle Tension Dysphonia (MTD)

Muscle Tension Dysphonia is a condition characterized by excessive muscle strain in the throat during speech. It can result from stress, poor vocal technique, or compensatory behaviors following an illness or injury. Individuals with MTD may experience vocal fatigue, tightness in the throat, and difficulty projecting their voice.

Exercise-Induced Laryngeal Obstruction (EILO)

EILO is a condition in which the vocal cords temporarily close or restrict airflow during intense physical activity, leading to breathing difficulties. It is commonly mistaken for asthma but differs in that symptoms occur primarily during high-intensity exercise and resolve at rest. Management typically includes breathing techniques and laryngeal therapy to improve airway function.

Paradoxical Vocal Fold Motion (PVFM)

(Previously known as Vocal Cord Dysfunction, VCD) – Paradoxical Vocal Fold Motion is a disorder where the vocal cords involuntarily close or narrow during inhalation, instead of remaining open. This abnormal movement can cause shortness of breath, wheezing, throat tightness, and voice changes. PVFM is often triggered by stress, irritants, or exercise and is sometimes misdiagnosed as asthma. Treatment usually involves breathing exercises, speech therapy, and relaxation techniques to improve vocal cord coordination.

Parkinson's Disease

Approximately 50% of individuals with Parkinson’t Disease experience speech difficulties, including reduced volume, monotone speech, and unclear articulation. Effective speech therapy incorporates various exercises and techniques to enhance vocal clarity and strength – speech rate reduction exercises, vocal effort exercises, articulation exercises, practice in shortening phrases and chunking information, and techniques to increase breath support ensure adequate airflow for sustained speech.

Each of these conditions can significantly impact voice quality and overall vocal function. Proper diagnosis and treatment, often guided by a speech-language pathologist or otolaryngologist, are essential for effective management and recovery.

Our Treatment Includes

Speech-language pathologists are crucial in assessing and treating voice disorders. Thankfully, most voice issues respond well to short-term interventions. Voice therapy typically combines direct and indirect treatment techniques.

Direct techniques focus on addressing the underlying physiological changes needed to enhance vocal function, such as practicing Vocal Function Exercises and improving anterior tone.
Indirect techniques emphasize educating individuals on how the voice box functions and promoting better vocal hygiene.

Therapy may also include recommendations for assistive devices (e.g., voice amplifiers) to reduce strain on the voice.

Self-Directed Techniques

To maintain healthy vocal function and prevent voice issues, try the following:

✅ Reduce throat clearing

✅ Use an amplification system when needed

✅ Quit smoking

✅ Drink plenty of water

✅ Avoid caffeine

✅ Breathe through your nose when outside in cold weather

✅ Keep your neck and jaw relaxed (avoid clenching your teeth)

✅ Manage or eliminate acid reflux

✅ Avoid speaking loudly or excessively

✅ Rest your voice when necessary

If you have laryngitis, avoid whispering. Instead, speak softly or communicate by writing and allow your voice to rest as much as possible. Most importantly, be sure to follow the guidance provided by your voice SLP.