Dysphonia

Dysphonia: Description, Causes and Risk Factors:Dysphonia is a phonation disorder or voice disorder.DysphoniaYour voice box or larynx is a framework of cartilage containing vocal cords. These structures vibrate to produce the sound of your voice. Dysphonia is defined as altered voice production. An estimated 20 million Americans have dysphonia, the clinical umbrella term for a hoarse or raspy voice that can cause pain when speaking and make it difficult to communicate effectively.Types may include:Spasmodic dysphonia.
  • Spastic dysphonia.
  • Abductor spasmodic dysphonia.
  • Adductor spasmodic dysphonia.
  • Dysphonia plicae ventricularis.
  • Dysphonia spastica.
Causes and Risk Factors:Lumps or nodules on the vocal cords.
  • Inflammation of the larynx over a short (acute) or long (chronic) period of time.
  • Underactive thyroid gland.
  • Trauma - any kind of trauma, including surgery, to the vocal cords will inevitably cause scarring and hence affect the vocal fold function. The risk of permanent voice change therefore needs to be discussed prior to surgery on the larynx.
  • Vocal cord paralysis - some other surgical operations including removal of the thyroid gland and heart or lung surgery can damage the nerves to the larynx causing either temporary or permanent vocal cord paralysis.
  • Reinke's edema of the larynx.
  • Psychological - voice changes are not uncommon when people are under stress either at work or at home. Overuse, emotional stress, trauma and illness can cause chronic spasm, weakness, or scarring of the vocal cords.
Symptoms:Symptoms may include:Hoarseness/breathiness.
  • Inability to project or maintainnotes
  • Recurrent colds, sore throats.
  • Hypertension and palpitations.
  • Gastrointestinal symptoms.
  • Neurological problems such as dizziness, double vision, headache.
Diagnosis:Observation:Muscular strain observed during speech.
  • Head/neck posture and muscles affecting it
  • Position of the cartilages: thyroid; cricoid; and hyoid bon.
A standing examination, lookingat the patient's posture, in particularhis relationship of the head and neckposition, shoulder girdle, breathingand laryngeal position, would beperformed. Posture may be regardedas a contributing factor to theaetiology of dysphonia when iteffects the breathing or the positionof the larynx.Dysphonia is measured using a variety of examination tools that allow the clinician to see the pattern of vibration of the vocal folds, principally laryngeal videostroboscopy. Acoustic examination is also common, obtained by recording the sounds made during sustained phonation or whilst speaking. Another tool is electroglottography.Treatment:Treatment of dysphonia is mainly based on clinical findings and underlying causative factors.Conservative treatment includes avoiding vigorous use of the voice (singing, shouting) and throat lozenges. Acute laryngitis from a virus should resolve on its own. Acute laryngitis from a bacteria may be improved with an antibiotic. In gastroesophageal reflux disease, treatment with an acid blocker may be effective. Some cases of dysphonia can require surgical intervention.Speech Therapy: The speech therapist plays an important role in the assessment and treatment of patients with voice disorders, e.g. Reinke's edema, vocal cord nodules, and voice misuse. The therapy will take some weeks or months before any improvements are noticed and so the patient must be highly motivated.Preventive Measures:Identify and eliminate causative factors such as stress, smoking, and alcohol. The patient should not to smoke or drink alcohol as they act as irritants to the larynx.
  • Drink plenty of clear fluid to avoid a dry throat.
  • The patient should try not to stress the voice if he is in loud environment. Crying, shouting, and excessive talking or singing will only make the problem worse.
Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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