Voice and Larynx Disorders

Your voice serves as a powerful tool for communication and understanding, allowing you to express yourself and connect with others. Central to the production of human voice is the larynx, commonly known as the voice box, located in the front of your neck. Within the larynx, the vocal cords play a crucial role by vibrating and generating sound. When the larynx is affected by either partial or complete impairment, it can result in voice and throat disorders that impact speech and swallowing.

Understanding these disorders and the care provided by Dr Kleid can be a crucial step towards achieving optimal vocal well-being.

If you’re experiencing symptoms related to your voice and throat, it’s important to seek appropriate care. Dr Stephen Kleid, an expert in Ear, Nose, and Throat (ENT) disorders, offers a range of tailored procedures at his ENT clinic in Melbourne, Australia to address voice and larynx disorders based on your specific diagnosis.

What are Voice and Larynx Disorders?

Voice and larynx disorders are a large category of conditions that affect your ability to speak. These various disorders also affect how you perform necessary daily activities like eating and drinking.

Research suggests that frequent and prolonged abnormal vocal function can lead to pathological damage to your larynx. In other words, complications can arise if your voice and throat problems are left untreated.

Although anyone can develop a voice disorder, they are more likely to cause occupational impairment for jobs that involve communication, such as with singers, teachers, sales people or public speakers.

The most common voice and throat disorders are rarely life-threatening, however permanent damage caused by these disorders can lead to major lifestyle changes.

Types of Voice and Throat Problems

Different voice and throat or larynx disorders can affect your vocal quality. These can develop because of anatomical and neurologic factors, as well as inappropriate use of your vocal mechanism. Different throat and voice problems include;

Laryngeal Cancer

Laryngeal or throat cancers begin in the squamous cells covering the inside of your larynx (either the voice box or lower throat).

Cancerous cells grow uncontrollably in the larynx, which in turn can cause a sore throat and pain, as well as, difficulty breathing or swallowing. If not treated immediately, cancer can spread.

Furthermore, smoking and drinking alcohol put you at a higher risk of developing laryngeal cancer. When discovery occurs early, laryngeal cancer has a high chance of being treatable.

Laryngitis

Infections and voice overuse can cause inflammation of both the larynx and the vocal cords within. Normally, your vocal cords open and close smoothly to create vibrations responsible for forming sound. Swollen vocal cords distort the sound, resulting in a hoarse voice. Laryngitis can either be acute, short-term, or chronic, long-term, laryngitis. Furthermore, if left untreated hoarseness can often lead to a more serious condition.

Vocal Cord Polyps

Vocal polyps, also known as non-cancerous nodules, can develop on the vocal cords as a result of vocal overuse or post-traumatic injury. These polyps are characterized by inflammation and can lead to various vocal symptoms, including hoarseness, loss of vocal range, and even complete loss of voice.

It is particularly common among individuals who engage in occupations that involve excessive laryngeal muscle tension, such as singers and radio personalities. Recognizing the signs and understanding the underlying causes of vocal polyps is essential in order to seek appropriate treatment and prevent further complications.

Spasmodic Dysphonia

Dysphonia is a term meaning disorder of the voice. Spasmodic dysphonia is a rare, neurological condition that affects the nerves that supply the laryngeal muscles. Most cases are thought to be caused by central nervous system disorders.

It causes involuntary muscle spasms that cause your voice to sound either weak, strained, or strangled. Furthermore, the spasms can be strong enough wherein your vocal cords can’t open.

Vocal Cord Paralysis

When the movement or opening of your vocal folds is impaired, it can be attributed to conditions such as paralysis or reduced movement ability, also known as hypomobility. Hypomobility can occur as a result of various issues involving the nerves, muscles, or joints.

Vocal cord paralysis, a form of hypomobility, can significantly impact your speech and lead to persistent coughing. Additionally, it may cause symptoms such as shortness of breath, as the proper functioning of the vocal folds is crucial for normal respiratory function. Identifying the signs of vocal cord paralysis and understanding its underlying causes is important in order to seek appropriate medical attention and explore potential treatment options.

Laryngeal Stenosis

Laryngeal stenosis refers to the narrowing of the airways and windpipes due to factors such as scarring or paralysis of the vocal cords. This condition can be either congenital, meaning present from birth, or acquired during one’s lifetime. Acquired laryngeal stenosis is often caused by factors such as infections or trauma to the larynx.

• Infections can lead to inflammation and subsequent scarring, resulting in the narrowing of the airway.
• Traumatic events, such as injuries or surgeries involving the larynx, can also contribute to acquired laryngeal stenosis.

Recognizing the symptoms and understanding the underlying causes of laryngeal stenosis is crucial for proper diagnosis and treatment. If you experience difficulties with breathing, voice changes, or other related symptoms, it is important to consult with a qualified medical professional for evaluation and appropriate management options.

Laryngopharyngeal Reflux (LPR)

Laryngopharyngeal reflux (LPR) is a condition commonly known by other names such as heartburn, acid reflux disease, or Gastroesophageal reflux disease (GERD). It occurs when the acidic contents of the stomach flow upward into the throat, causing irritation to the larynx and vocal cords.

One of the hallmark symptoms of LPR is a burning sensation in the chest, which often occurs after eating, stretching, lying down, or exercising. This discomfort arises due to the regurgitation of stomach acid into the esophagus and throat.

The good news is that LPR symptoms are typically temporary and can be effectively managed through lifestyle changes. By making certain adjustments to your habits and diet, you can help reduce the occurrence and severity of acid reflux episodes.

Seeking guidance from a healthcare professional can provide further insights into managing LPR and improving your overall well-being.

Vocal Cord Hemorrhage

Excessive screaming or prolonged loud speaking can place unnecessary strain on your vocal cords, leading to physical stress. This strain can cause the blood vessels in your vocal cords to rupture.

While this condition is not life-threatening, it can interfere with the normal function of your vocal cords. The ruptured blood vessels may result in symptoms such as hoarseness, vocal fatigue, and discomfort. In some cases, it can even lead to aphonia, which is a temporary loss of voice.

If you experience these symptoms after engaging in activities that strain your vocal cords, it is important to give your voice a rest and allow your vocal cords to heal. Refraining from excessive shouting or speaking loudly can help prevent further damage and promote the recovery of your voice. If symptoms persist or worsen, it is advisable to seek medical attention for proper evaluation and guidance on vocal care.

Paradoxical Vocal Fold Movement (PVFM)

Paradoxical Vocal Fold Movement (PVFM) is a condition characterized by the improper movement of the vocal folds, which are responsible for controlling the airflow during speech and breathing. This abnormality in vocal cord function can be attributed to various underlying factors.

PVFM can be triggered by different causes, such as viral infections, previous thyroid gland or chest surgeries, and prolonged or incorrect use of breathing tubes. These factors can disrupt the normal coordination between the muscles that control the opening and closing of the vocal folds, leading to their inappropriate closure during inhalation instead of the typical opening.

The symptoms of PVFM can vary but often include; difficulty breathing, a feeling of tightness or constriction in the throat, and episodes of shortness of breath or wheezing. These symptoms can be alarming and may mimic other respiratory conditions, making an accurate diagnosis important.

Laryngeal Papillomatosis

Laryngeal papillomatosis is a chronic viral infection that affects the voice box and throat, resulting in the development of small nodules or growths. These benign tumors can appear in various parts of the respiratory tract, including the throat, voice box, vocal cords, and the airway from the nose to the lungs. As a result, individuals with laryngeal papillomatosis may experience a range of symptoms.

One underlying cause of laryngeal papillomatosis is the human papillomavirus (HPV). Unfortunately, a definitive cure for this condition has not yet been discovered. However, the current standard treatment approach involves surgical removal of the papillomas.

It’s important for individuals with laryngeal papillomatosis to work closely with their healthcare provider to manage the symptoms and monitor the growth of the papillomas. Regular follow-up appointments and ongoing surveillance are crucial in order to detect any recurrence or progression of the disease. Additionally, various supportive therapies, such as speech therapy or voice rehabilitation, may be recommended to help individuals regain optimal vocal function and cope with any voice-related challenges.

What are the Symptoms of Voice and Larynx Disorders?

Voice and throat disorders can manifest with various symptoms depending on their underlying cause and severity. These symptoms are commonly observed in individuals who heavily rely on their vocal function, such as teachers, lawyers, professional voice personalities, and others in similar occupations.

The primary symptoms of voice disorders often affect the quality of the voice itself. They may include:

• Changes in pitch
• Weakened sound
• Strained or choppy sounds
• Raspy or hoarse sounds
• Voice sounding too high or too low
• Whispering sounds
• Unstable or quivering sounds
• Breathy sounds

In addition to voice quality issues, there are other symptoms that may arise and are not directly related to the voice:

• Tension or pain experienced while speaking
• Presence of a lump in the neck
• Sensation of a lump in the throat while swallowing
• Discomfort during speaking
• Persistent sore throat
• Chronic cough
• Difficulty breathing
• Shortness of breath during singing, exercising, or talking
• Pain while speaking or swallowing
• Aphonia, which is the partial or complete loss of voice
• Weak voice

It’s important to note that experiencing any of these symptoms may indicate the presence of a voice or throat disorder. If you are encountering persistent or bothersome symptoms, it is recommended to consult with a healthcare professional, such as an ear, nose, and throat specialist or a speech-language pathologist, who can provide an accurate diagnosis and develop a personalized treatment plan to address your specific condition.

By seeking appropriate medical attention and implementing appropriate interventions, individuals with voice and throat disorders can often achieve improved vocal function and regain optimal communication abilities.

How are Voice and Larynx Disorders Diagnosed?

Some signs of voice disorders are common in illnesses, like the flu, making it difficult to know whether you have a voice or throat problem. Notice any unusual changes in your voice or pain in your throat? Come and get yourself thoroughly checked by Dr Kleid.

To evaluate and diagnose voice and throat disorder, Dr Kleid will order one or more of the following:

• Imaging tests: Dr Kleid uses CT scans, Magnetic Resonance Imaging (MRI), or X-rays, to see the inside of your throat and check for any abnormalities.
• Biopsies: He may request a tissue sample be removed to be examined for signs of cancer.
• Laryngeal Electromyography (EMG): This makes use of tiny needles called electrodes. We connect these to a computer system to check the electrical activity of your throat muscles. Dr Kleid uses this to check if the nerves in your throat are damaged.
• Laryngoscopy: He can use a specific device called a laryngoscope to view the inside of your larynx, including the vocal cords and nearby structures.
• Videostroboscopy: Dr Kleid can perform endoscopy with a video recorder to examine the vibrations of your vocal cords during speech. It evaluates the function and health of your vocal cords.

What are the Complications of Voice and Larynx Disorders?

Complications can arise from voice and larynx disorders when symptoms are prolonged and left untreated. Without appropriate intervention, these conditions can lead to more serious and potentially permanent damage. Some of the potential complications include:

• Vocal cord paralysis
  • When the vocal cords are unable to move properly or are completely immobile, it can result in vocal cord paralysis.
  • This can significantly impact speech and voice production.
• Permanent loss of voice
  • If voice disorders are not addressed and managed promptly, there is a risk of permanent loss of voice, also known as aphonia.
  • This can have a profound impact on communication and quality of life.
• Progressive nerve damage
  • Certain voice and larynx disorders can cause damage to the nerves involved in vocal cord function.
  • If left untreated, this damage can progress and potentially lead to more severe impairments.
• Metastatic throat cancer
  • In some cases, untreated voice and throat disorders can increase the risk of developing throat cancer.
  • It is important to address any persistent or concerning symptoms to prevent complications such as cancerous growths.

Treating voice and larynx disorders is crucial to restore and maintain normal vocal function. While the recovery process may take time, seeking appropriate medical care and adhering to recommended treatment plans can help prevent long-term complications. It is essential to consult with a healthcare professional, such as an ear, nose, and throat specialist or a speech-language pathologist, to receive a proper diagnosis and develop an individualized treatment approach that best suits your specific condition. By addressing voice and throat disorders in a timely manner, you can improve your chances of avoiding complications and achieving optimal vocal health.

What are the Treatments for Voice and Larynx Disorders?

Voice and throat problems are rarely life-threatening but, when left untreated for too long, your symptoms can grow into something more serious.

Surgery

Dr Kleid usually performs surgery for voice and larynx disorders when your voice box loses its function, such as vocal fold paralysis, vocal fold polyps, and scarring of the vocal folds.

• Thyroplasty
  • To access your vocal cords, Dr Kleid creates an opening in the neck and opens the cartilage of your larynx.
  • He inserts an implant through the hole to move the vocal cords into position.
  • The implant brings the two vocal cords closer, making speech possible and less demanding.
• Laryngeal Reinnervation
  • In patients with laryngeal nerve paralysis, Dr Kleid can surgically replace a damaged nerve in your throat or voice box.
  • He takes a healthy nerve, the ansa cervicalis nerve, from your neck to reinnervate the recurrent laryngeal nerve and relieve the symptoms of vocal fold paralysis.
• Lesions removal
  • This procedure is used to remove non-cancerous, precancerous, and cancerous vocal fold lesions causing voice problems.
  • Potassium Titanyl Phosphate (KTP) laser surgery is the latest laser treatment that allows Dr Kleid to remove vocal cord lesions while preserving the surrounding tissue.

A multidisciplinary approach with the help of an otolaryngologist or ENT surgeon, such as Dr Stephen Kleid, and a speech-language pathologist may be the best course of action to develop a medical treatment plan.

Medication

Prescribing medication for voice and throat problems depends on the cause of your disorder. Dr Kleid can prescribe medication to treat inflammation, gastroesophageal reflux, or prevent the regrowth of certain tumour’s.

Injections

For disorders that induce tremors in your throat muscles, Dr Kleid can treat them by injecting Botulinum toxin into the skin of your neck. Botulinum toxin injections can reduce both irregular movement and muscle spasms in disorders like spasmodic dysphonia.

Speech Therapy

Early identification and diagnosis of a problem are the key to successful treatment. Often, voice therapy is the primary treatment of voice disorders. Even vocal nodules can be treated with the help of a speech pathologist if diagnosed early.

How is the Recovery after Surgery?

After treatment or surgery, you may not be able to talk immediately. There is a chance you could lose your voice or gain it back after some days or weeks.

You may need the help of a speech therapist, speech-language pathologist, or physical therapist to both improve your vocal cord functions and also strengthen them.

FAQs

What are voice disorders?

These are disorders that affect the pitch, tone and overall quality of your voice and your throat condition.

Who develops voice disorders?

Anyone, regardless of age or sex, can develop voice disorders. They are common disorders among teachers and singers, as well as, other professionals that use their voices constantly.

What causes a voice disorder?

Growth of abnormal tissue in your vocal cords, hormonal problems, nerve damage, inflammation and swelling as well as, misuse or overuse of your voice can all contribute to voice disorders.

If I have a hoarse voice, should I see a doctor?

Yes. Especially when you have symptoms that persist for long periods. If your voice disorder is not yet serious, Dr Kleid may recommend you consult a speech pathologist.

What are the different types of voice disorders?

The different types of voice disorders include laryngitis, spasmodic dysphonia, vocal cord paralysis, laryngeal cancer, and others.

Sources

• The Risk Factors Related to Voice Disorder in Teachers: A Systematic Review and Meta-Analysis
• Prevalence of Voice Disorders in Singers: Systematic Review and Meta-Analysis
• Voice disorders in teachers. A review
• Functional Voice Disorders – StatPearls – NCBI Bookshelf
• Hoarseness—Causes and Treatments – NCBI
• Voice disorders – Symptoms and causes – Mayo Clinic
• Acute Laryngitis: Practice Essentials, Pathophysiology
• Functional Voice Disorders: Overview, Evaluation, Etiology

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Why Choose Dr Kleid for Ear, Nose and Throat Surgery?

Dr Stephen Kleid
Ear Nose and Throat Surgeon (Otolaryngologist)
MED0001052799

Masada Medical Centre
26 Balaclava Road,
East St Kilda, Victoria

Dr Stephen Kleid is an experienced Ear, Nose and Throat ENT Surgeon (Otolaryngologist) based in St Kilda.

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