Voice impairment has many causes
Approximately 17.9 million people in the United States have dysphonia, or trouble using their voices, according to the National Institutes of Deafness and Communication Disorders.
Dysphonia is defined as an abnormal sound of the voice, including hoarseness. Symptoms of hoarseness relate to problems in the sound-producing parts (vocal cords or folds) of the voice box or larynx. This results in a raspy, weak, or airy voice.
According to the American Academy of Otolaryngology, when judged by a health care provider, dysphonia may include:
- an abnormal voice quality,
- pitch (how high or low),
- diminished volume (loudness), or
- excessive vocal effort to communicate.
Dysphonia International is dedicated to being a resource for persons with spasmodic dysphonia (SD) and related voice conditions, including muscle tension dysphonia, vocal tremor, and vocal cord paralysis. These specific causes of dysphonia are our current focus. We offer resources, tools and for people with SD, and we are building a collection for related disorders.
Dr. Robert Bastian, Director of the Bastian Voice Institute in Downers Grove, IL, categorizes vocal conditions as neurological, vocal cord vibratory injuries, benign lesions, inflammation, tumors, functional/nonorganic, and miscellaneous. He has generously shared his descriptions of voice disorders by cause. Full descriptions of these voice disorders can be found on his teaching website, Laryngopedia (www.laryngopedia.com).
Neurological Voice Disorders
Disorders of the nervous system (neurological) can affect the voice in different ways.
— Essential voice tremor
— Neuromuscular disorders (like ALS)
— Palate paralysis (affecting resonance more than voice quality)
— Parkinson’s disease-related voice change
— Spasmodic dysphonia (Laryngeal dystonia)
— Vocal cord paralysis
— Vocal cord paresis
Vocal Cord Vibratory Injuries
Common disorders that affect the voice are vibration-induced lesions, or injuries, of the surface layer of the vocal cords, called mucosa. This kind of injury usually happens when a person overuses or abuses his or her voice.
— Capillary ectasia
— Epidermoid cyst
— Glottic furrow
— Glottic sulcus
— Indicator lesions (subtle swellings)
— Mucosal bridge
— Mucosal edema or swelling
— Open epidermoid cyst
— Hemorrhagic polyp
— Polypoid degeneration (aka Reinke’s edema or smoker’s polyps)
— Submucosal fibrosis
Other Benign Lesions
These are benign lesions or conditions that occur in the larynx but, unlike vocal cord vibratory injuries, usually without correlation to excessive voice use.
— Anterior commissure microweb
— Contact granuloma (also see granulation tissue)
— Glottic web
— Keratosis (seen as leukoplakia)
— Laryngopharynx acid reflux disease (LPRD)
— Mucus retention cyst
— Post-radiation telangiectasia
— Saccular cyst
— Supraglottic cyst
— Vallecular cyst
Laryngitis is a general term for inflammation of the larynx. There are different variants and causes.
— Acid reflux
— Gastroesophageal reflux disease (GERD)
— Laryngopharynx acid reflux disease (LPRD)
— Auto-immune laryngitis
— Bacterial laryngitis
— Candida laryngitis and pharyngitis, caused by candida albicans, a commensal organism
— Cryptococcus neoformans
— Laryngitis sicca
— Post-surgical laryngitis
— Radiation mucositis
— Rheumatoid nodules of the vocal cords
— Ulcerative laryngitis
— Viral laryngitis
A tumor is considered malignant if it has the potential to invade or spread to other tissues.
— Carcinoma in situ (CIS)
— Verrucous carcinoma
A tumor is considered benign if it doesn’t pose the threat of invading or spreading to other tissues.
— Recurrent respiratory papillomatosis caused by human papillomavirus (HPV)
Nonorganic Voice Disorder
Nonorganic voice disorders arise not from abnormality of the mechanism itself but instead from abnormal use of the mechanism, most often for conscious or subconscious secondary gain.
Functional Voice Disorders
Functional voice disorders arise not from abnormality of the mechanism itself but instead from abnormal use of the mechanism, affected by personality or deficit of vocal skill, without discernible secondary gain.
— Disorder of vocal loudness perception
— Muscular tension dysphonia (MTD)
— Vocal fry dysphonia
— Vocal overdoer syndrome
— Vocal underdoer syndrome
— Vocal “vincibility” syndrome
— Voice fatigue syndrome
Miscellaneous Voice Disorders
These are other disorders, terms, or descriptors used in the realm of voice and larynx disorders.
— Arytenoid chondritis / perichondritis
— Bilateral vocal cord fixation
— Bowing of the vocal cords
— Breathy dysphonia
— Breathy-pressed phonation or dysphonia
— Flaccidity of vocal cords
— Fracture of larynx
— Intubation injury
— Marfan syndrome
— Perimenopausal voice change
— Phonatory insufficiency
— Vocal cord scissoring