What
is a Voice Disorder?
Any
condition that affects the performance of the voice-producing
organ – the larynx – can
cause a voice disorder. Usually, hoarseness is the main symptom,
but laryngeal disorders can cause other, more subtle problems.
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Common
Symptoms of Laryngeal Disorders
Hoarseness or breathiness of
the voice
Voice breaks
Limitations in pitch range
Limitations in volume and projection
Difficulty making oneself understood
over background noise
Voice ‘fatigue,’ or
discomfort and deterioration of the voice with prolonged
use
Breathlessness while talking
Chronic throat clearing or coughing
Difficulty breathing or swallowing |
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wide variety of conditions can cause laryngeal dysfunction. A more
complete description of each of these can be found by selecting
the diagnosis of interest at left. |
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Any
hoarseness that persists beyond two weeks, especially in a smoker,
should be evaluated by a physician who can inspect the vocal
cords. |
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| Voice
disorders can be highly subjective: that is, what may be a serious
problem for one person may present little difficulty to another.
Some of this has to do with a given person’s expectations,
but a key factor is vocal demand.
Simply put, vocal demand describes the vocal requirements of a
given person’s daily life. Clearly, a singer or an actor
will have different vocal demands from a teacher or a trial attorney,
who in turn will have different vocal demands from someone who
does most of his or her work on a computer keyboard, or someone
who cares for a hearing-impaired individual.
There is no established way
to quantify vocal demand. Generally, though, the
longer and the louder one must voice throughout the
day, the greater the vocal demand, and the more likely
small irregularities in laryngeal function are to
be troublesome. Also, different types of voicing – for
instance, professional vocal performance – have
lower tolerance for subtle changes in voice quality
than others.
The professions most commonly
evaluated for voice disorders are performing artists,
teachers, attorneys, salespeople and other customer
service personnel.
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Because
voice quality is subjective and vocal demands vary, the person
with the disorder is usually the best judge of the severity and
importance of the problem (assuming it is non-cancerous), and
whether it justifies a proposed treatment. |
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In
benign voice
disorders, the role of the physician is to make an accurate diagnosis,
and explain what options are available, including discussions of
expected outcome and attendant risks. Needless to say, a physician
who is fully informed of both your symptoms and of your vocal needs
is best equipped to offer advice tailored to your problem.
Ultimately, a treatment decision,
and especially the decision for surgery,
should be made together with your physician, taking
into account your vocal behaviors and vocal demands.
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