Voice Disorders

Voice Disorders encompass a wide variety of conditions that affect the voice box (larynx). Infective, inflammatory, structural, traumatic, mass lesions – benign (e.g. Vocal Nodules Fig. 1) and malignant, neurological, endocrinal, vascular, autoimmune to name a few of the causes that can manifest with a change in voice. The management involves a thorough understanding of the laryngeal function, diagnostic evaluation with attention to detail and a multidisciplinary team approach in treatment.

How common is Voice Disorders and which groups of individuals are generally affected?

It is estimated that between 3 – 10% of the general population are affected by voice disorders. This is of particular concern in ‘voice professionals’ the term used to designate those individuals who depend on their voice for their profession like teachers, singers, lecturers and even doctors! The main symptom in people with voice disorders is hoarseness or dysphonia, which describes an alteration in voice quality.

What happens in the Voice Clinic? How are Voice Disorders diagnosed?

The evaluation and assessment of a patient with voice disorders is carried out by the ENT Consultant, he or she may seek an opinion from the Speech therapist. A thorough assessment is carried out by Diagnostic and Physical evaluation by the consultant using specialist equipment for Laryngeal evaluation including rigid and flexible laryngoscopes and video stroboscopy. On occasions the accurate diagnosis is established after Perceptual evaluation and specific imaging and blood tests.

How are Voice Disorders treated?

There are three general approaches to the management of voice problems: medical, surgical, and behavioural including speech therapy. It is often the case however, that optimal treatment requires the use of a combination of treatment types.

Medical Management

The medical approach to the treatment of voice disorders refers to non-invasive techniques. Laryngeal problems in which the vocal cords demonstrate redness, swelling or irritation (e.g. laryngopharyngeal reflux) can be medically treated. Proton pump inhibitors used to control and treat acid reflux play an important role.

Surgical Management (Phonosurgery)

A thorough understanding of the structured micro-anatomy of the true vocal cord is implicit to effective management. Vocal fold cysts, polyps, swelling (oedema) and other benign, precancerous and malignant conditions are treated surgically.

Speech Therapy and Behavioural Management

The behavioural approach consists of voice therapy which aims at restoring the best voice possible within the patient’s anatomical, physiological and psychological capacity. The information above should serve as a general guide only.