Dysphonia and Other Voice Disorders

When nationally renowned touring performers or stage-commanding opera singers have pain while singing or hoarseness in their voice, it can be catastrophic to not only their livelihood but also their ability to enjoy life.

That’s why many of them turn to the dedicated Voice Center at The Ohio State University Wexner Medical Center in Columbus, Ohio, for help. As a destination for voice disorder treatment, we have experts specially trained in healing voice problems with a variety of methods beyond surgery.

Our experts include five fellowship-trained laryngologists — the most in the Midwest region — as well as speech pathologists who are classically trained opera singers and nurses who work solely with people struggling with voice problems.

We specialize in paradoxical vocal cord motion disorder (PVCMD) — a vocal cord abnormality that mimics asthma — and see more people with this condition than most other hospitals in the country. While those who sing and use their voice in a professional setting can be more at risk for these issues, we recognize how important everyone’s voice is, whether you’re a teacher, restaurant server or CEO, and will work to restore your voice.

What is dysphonia?

Dysphonia is the medical term for a group of disorders that affect your voice. Excessive talking, straining and constantly clearing your throat can lead to these voice disorders. Other causes of dysphonia include:

• Acid reflux
• Vocal cord paralysis from disease
• Growth due to viruses or cancer
• Vocal cord polyps or lesions
• Infections
• Hormones
• Paradoxical vocal cord motion disorder
• Laryngitis or pharyngitis

When you experience dysphonia, your voice changes and, in some cases, might be unrecognizable. Other signs and symptoms of a voice disorder include:

• Your voice becomes hoarse or raspy.
• Your voice suddenly sounds deeper.
• Your throat often feels raw, achy or strained.
• You struggle to talk without breaks or at all.
• You lose the ability to hit some high notes while singing.

Types of dysphonia

There are various conditions that fall under the umbrella of dysphonia. They affect different parts of your larynx (voice box), vocal cords or other throat structures. A few common types of dysphonia are:

Hoarseness

Hoarseness occurs when the vocal cords become inflamed, swollen or irregular. The swelling that results is what causes hoarseness, a rough and raspy sound to your voice. Cold and sinus infection are usually to blame for hoarseness and it takes about two weeks for hoarseness to get better.

Spasmodic dysphonia

When the condition called spasmodic dysphonia exists, muscles that control the vocal cords spasm due to overactive signals from the brain. Botulinum toxin is injected into the muscles to block the signals, which reduces the intensity and amount of spasms.

Functional dysphonia

This happens when your voice quality is impacted by something other than anatomical, neurological or other organic difficulty. It’s typically the result of overuse of certain muscles in the throat and larynx.

Muscle tension dysphonia

Your voice can change because of too much muscle tension in and surrounding your larynx. This can include the vocal folds, which are muscles in the voice box.

Additional voice disorders

There are many other conditions that impact the way we talk and communicate. A sampling of the ones we treat here at the Ohio State Wexner Medical Center include:

Paradoxical vocal cord motion disorder (PVCMD)

Paradoxical vocal cord motion disorder (PVCMD) is when your vocal cords have episodes of closing instead of opening as you breathe. This condition makes getting air in and out of your lungs difficult, and it mimics asthma.

Laryngitis

Inflammation of the voice box (larynx) accompanied by hoarseness or loss of voice is laryngitis. Viral infection from a cold or flu is usually to blame for laryngitis, but it can also be caused by allergies, injury or pneumonia.

Laryngocele

When air sacs in your voice box bulge out, they can obstruct your airway or create hoarseness. These bulges are called laryngoceles and while they’re usually benign, they can cause discomfort or annoyance and should they become infected, they may need to be removed.

Laryngopharyngeal reflux

When the muscle at the top of the esophagus — called the upper esophageal sphincter — doesn’t close properly, stomach acids can bubble up all the way to the throat and even nasal cavities. That’s when laryngopharyngeal reflux occurs.

Vocal cord cancer

The larynx is a part of the throat, between the base of the tongue and the trachea. The larynx contains the vocal cords. Using tobacco and excessively using alcohol are the greatest risk factors for laryngeal cancer, which affects more than 12,000 people in the United States each year.

Vocal cord lesions

Vocal cord lesions are noncancerous (benign) growths inside or outside of the vocal cords. They are one of the most common causes of voice problems and can be cysts, nodules or polyps. Lesions that are a result of trauma and located opposite existing vocal cord lesions are called reactive.

Vocal cord paralysis

When nerve impulses in your voice box (larynx) are interrupted, your vocal cord muscle can become paralyzed. When this happens, speaking and breathing can both be affected. Damage to nerves during surgery, infection, neurological disorder and cancer can be the cause of vocal cord paralysis.