Voice Disorders – Causes of a Hoarse Voice or Dysphonia

Everyone has had trouble with a hoarse voice or dysphonia at some point. Sometimes with a cold you may “lose your voice”. Maybe you yelled too loudly and strained your vocal chords. People can develop voice problems for multiple reasons.  But prolonged trouble with your voice is usually the result of a medical disorder. Failure to seek a physician’s care can lead to more serious problems. ENT doctors or doctors who specialize in ear, nose and throat disorders diagnose and treat voice disorders. 
Dysphonia - A hoarse voice or when the voice involuntarily sounds breathy, raspy, strained, with a softer volume or lower pitch.

Some Common Voice Disorders Include:

Laryngitis

Laryngitis is caused by a swelling of the vocal cords. This is usually due to an infection. A viral infection in the upper respiratory track is the most common cause for problems with the voice box. When vocal cords swell, they vibrate differently, which leads to hoarseness. The best treatment is to rest your voice drink plenty of fluids. Since usually caused by a virus, antibiotics don’t work. It is important to take care of your voice during laryngitis, because the swelling of the vocal cords increases the risk for serious injury. This can cause blood in the vocal cords or formation of vocal cord nodules, polyp, or cysts.

Vocal Cord Lesions

Benign or non-cancerous growths on the vocal cords can be caused by voice overuse, trauma or injury to the vocal cords. These bumps on the vocal cords change your vocal cord vibration. The abnormal vibration causes hoarseness and a chronic change in the quality of your voice. This can include a rough and raspy voice that makes it more difficult to speak.
Some vocal cord lesions or “singer’s nodes” are like calluses on the vocal cords. They usually happen on vocal cords that are opposite of one another. Treatments include voice rest and speech therapy. Vocal cord polyps or cysts are common vocal cord lesions caused by misuse, overuse, or trauma to the vocal cords. They frequently require surgical removal.

Vocal Cord Paralysis

Hoarseness and other vocal issues can be caused by problems between the nerves and muscles within the voice box or larynx. This includes paralysis or weakness of one or both vocal cords.
A paralyzed vocal cord usually causes a soft, breathy, or weak voice due to poor vocal cord closure. Recovery can happen on their own within several months. But there is a possibility that the paralysis may become permanent, which would require surgical treatment.

Gastroesophageal Reflux Disease or Laryngopharyngeal Reflux Disease

Acid Reflux into the throat from stomach acid can cause many issues in the esophagus and throat. Hoarseness, swallowing problems, and throat pain are common with gastric acid irritation in the throat.

Patients frequently wake up with throat irritation, hoarseness, and throat discomfort without understanding the cause. An otolaryngologist will perform an examination to determine if stomach acid is causing irritation of the throat and voice.

Poor Speaking Technique

Speaking at an abnormally or uncomfortable pitch (too high or too low) can lead to hoarseness and other voice problems.
Other factors include improper speaking technique, insufficient or improper breathing while talking, such as breathing from the shoulders or neck area instead of from the lower chest or abdominal area. Voice problems can also be caused from using your voice in an unnatural position, such as talking with the phone cradled on your shoulder.

Throat Cancer

Throat cancer is a very serious and requires immediate medical attention. When cancer attacks the vocal cords, the voice changes. This symptom occurs at the early stages of the cancer. Prompt attention to changes in the voice can facilitate early diagnosis and successful treatment of vocal cord cancer.

Chronic hoarseness or changes in the voice for more than 2 to 4 weeks in a smoker should be checked to determine if there is cancer of the larynx. Treatment options include surgery, radiation therapy, and/or chemotherapy. When vocal cord cancer is diagnosed early, usually surgery or radiation therapy is required, and the cure rate is high.

Risk Factors for Voice Disorders

There are many risk factors that can contribute to a voice disorder. These include:

  • Alcohol use
  • Allergies
  • Dehydration
  • Frequent throat clearing over a long period of time
  • Gerd or gastroesophageal reflux disease
  • Illness – colds, the flu, upper respiratory infections
  • Neurological disorders
  • Phycological stress
  • Scarring
  • Smoking
  • Throat Cancer
  • Thyroid Conditions
  • Voice Overuse
  • Yelling

Hoarseness or roughness in your voice is often caused by a medical problem. Contact Colorado ENT if you have any sustained changes to your voice. Call (719) 867-7800 to make an appointment today.

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