Human voice has multidimensional facets. You can express your emotions and feeling through your voice besides its use in normal verbal communication. However, not always your voice may sound clear. It may be whispery, hoarse, broken, strangled etc. The medical terminology used for disorder of voice is known as dysphonia.
People suffering from dysphonia may present with pain, hoarseness and dryness in the throat. These people are unable to produce large clear voice. They find it difficult to sing in upper note. Dysphonia can occur due to various causes such as inflammation of the voice box, node in the vocal cord, thyroid gland disorder, injury to larynx, etc.
Fortunately the cause for dysphonia in most people is not dangerous. The condition is relieved with speech therapy, medical and other conservative approach. Surgery may be required in some cases to remove the tumor or a node that disrupts the voice.
Before we know the cause, let us have a brief view on how voice is generated. Just like a sound system in discotheque, human also needs a sound system that is able to generate voice. It is centrally controlled by brain with intermediate wiring in the form of nerves. The sound producing system comprises of larynx or the voice box, vocal cords, and articulated movement of tongue, lower jaw, and upper soft palate of the mouth.Thus the words that you speak are made up of voice sound, resonance and articulation.
Basic sound is produced by the vocal cords. The sound produced resonates in throat, mouth, nasal cavity, which makes it more amplified. The tongue, soft palate and lips articulate and modify the sound and make it recognizable as words. The brain controls action of all the organs that take part in voice production such as chest muscles, diaphragm, larynx, pharynx, tongue, lips, and lower jaw. The laryngeal nerve branching from 10th nerve sends messages to these organs to act to produce voice.
What Are The Causes Of Dysphonia?
There are several causes of dysphonia such as.
- Irritation and inflammation due to continuous and prolonged overuse of voice box.
- Injury to the voice box due to instrumentation, foreign body, chemicals etc.
- Paralysis of vocal cord can sometimes occur as a result of thyroid surgery, or heart surgery. The nerve supplying message to the larynx may get damaged during the surgery which may lead to permanent or temporary loss of voice due to vocal cord paralysis.
- Edema of the larynx.
- Node on the vocal cord is common in singers or speakers who overuse their voice.
- Certain psychological factors such as stress and anxiety can cause sudden changes in the voice. It can also occur due to cold.
Signs And Symptoms Of Dysphonia
Person suffering from dysphonia may have hoarseness of voice, sore throat and dryness. The patient may have sudden difficulty in speaking words. Their voice may break in the middle of their speech, especially during speaking certain words. He may feel that he needs more effort and energy to talk words than before.
A singer may not be able sing in the high note. His voice may sound strained and strangled. His voice may be heard like whisper. He is unable to speak loudly and clearly. There is abrupt change in the pitch of voice while speaking.
There is tightness and choking sensation in the throat while speaking. Patient always feels a lump in the throat when he has dysphonia which he feels to clear it often.
Treatment Guidelines For Dysphonia
Patient who has hoarseness of voice for more than one month should consult an ENT specialist. Since there are many causes of dysphonia, the treatment is calibrated according to the underlying cause. The first line of management always begins with conservative medication and therapy.
- Patient is advised to stop smoking, drinking alcohol and reduce stress. He is also advised to drink more water and fluid to keep his throat moist. He has to give complete rest to his voice box. Thus he should stop speaking and taking for one or two days. During this period he can use other communication modes such as writing.
- Patient may need speech therapy in certain cases such as paralysis if voice box, and nodes on the vocal cord. This therapy may take few months for the result.
- Sometimes anti inflammatory and antibiotics may be necessary to reduce infection and inflammation of the larynx.
- Some cases of dysphonia may need to be treated with surgery. It is always necessary in cancer of larynx.