Voice Disorders


Awareness of voice:
Horase voice may sound breathy, scratchy, husky or strained. Voice changes are due to disorders of the vocal cord ( Sound producing part) of the larynx. i.e. Voice box when a person breaths. Vocal cords go apart while when speaking or singing they come close to each other as air passes from the lungs which causes their vibration which in turn reduces sound. When there is swelling over the vocal cord this hinders the vibrations thus altering voice quality, volume and pitch.

Causes
Acute Laryngitis Diffuse swelling vocal cords occur due to common cold, URIT ( Upper respiratory track infection ), viral infection or from voice abuse like shouting which usually resolves with  appropriate treatment & voice rest.

VOCAL NODULE
Commonly seen in children, teachers as well as singers. Usually referred to as SINGERS NODULE, common cause of hoarse voice.

VOCAL POLYP
Mostly seen in people with excessive use of voice and smokers.

GASTROESOPHGEAL REFLUX ­­GERD or LER
Due to lax lower oesophageal sphinter there is reflux of acid into the Pharynx & Larynx clearing of which can cause Laryngopharyngitis.

Symptoms
 Frequent Throat Clearing.
Water brush, fluid coming from mouth.
Throat irritation
Change in voice


VOCAL CORD CANCER

Common cause of hoarse voice in elderly persons .

Neurological Disorders
Neurological problems like parkinsonism & stroke can result in detoriation of voice
Cause of phasic pattern & change of voice

VOCAL CORD PARALYSIS
Paralysis of vocal cord occurs due to
Surgery of thyroid gland
Idiopathic
Viral Infection

Here patient has husky , breathy voice. Mostly recovers within six weeks, along with steroid therapy. It does not recover then one can undergo surgery like Thyroplasty.

 How to treat Hoarseness?
 Treatment depends on the cause of hoarseness.. It can be medical management. If it does not recover, then surgical treatment along with speech therapy.

 Diagnosis
 If hoarseness persists for more than 3 weeks then it needs to be evaluated. We do fiber optic laryngoscopy by passing a thin fibreoptic scope through the nose. Into the throat and examining the vocal cords.Recording of the findings can be done at the same sitting.

 Stroboscopy
 It is slow motion assessment of vocal thereby assessing the vibratory pattern & amplitude of vocal cord movement.

THYROPLASTY:
There are four types of THYROPLASTIES. Depending on the position of the vocal cords.

TYPE 1 ­Mediliasation Thyroplasty for unresolving unilateral vocal cord paralysis.
TYPE II­ Lateratisation Thyroplasty
TYPE III­ For Pubophonia in matters with high pitch voice . Here the vocal cords are relaxed thereby decreasing the pitch of the vocal cords.
TYPE IV­ This is done in females with low pitch voice. We routinely do thyroplasty at

BALAJI ENT & HOSPITAL
Time to see OTOLARYNGOLOGISTS/ ENT specialist
 If hoarseness persists for more than 3 weeks
If you are loughing blood
If having difficulty or pain while swalloing
If there is difficulty in breathing with change in voice
If hoarseness of voice is hampering day to day activity.
If you are singer or teacher.

To prevent Hoarseness
Speech therapists are trained to assist people in behavior modification to eliminate disorders, people with habit of smoking, over use of voice benefit more than speech therapy. Speech Therapy is also helpful in treatment of vocal module and vocal cord haemorrhage.

 TIPS
   Avoid smoking.
   Avoid speaking too long & too loudly.
   Drink plenty of water to hydrate vocal cords.
   Avoid spicy & cold food.
   Use microphone if you need to talk too loud.
   Avoid speaking when voice is hoarse.