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
bullet Frequent Throat Clearing.
bullet Water brush, fluid coming from mouth.
bullet Throat irritation
bullet Change in voice
VOCAL CORD CANCER

VOCAL CORD CANCER

bullet Common cause of hoarse voice in elderly persons .

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

VOCAL CORD PARALYSIS
Paralysis of vocal cord occurs due to
bullet Surgery of thyroid gland
bullet Idiopathic
bullet 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
bullet If hoarseness persists for more than 3 weeks
bullet If you are loughing blood
bullet If having difficulty or pain while swalloing
bullet If there is difficulty in breathing with change in voice
bullet If hoarseness of voice is hampering day to day activity.
bullet 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
 bullet  Avoid smoking.
 bullet  Avoid speaking too long & too loudly.
 bullet  Drink plenty of water to hydrate vocal cords.
 bullet  Avoid spicy & cold food.
 bullet  Use microphone if you need to talk too loud.
 bullet  Avoid speaking when voice is hoarse.