Voice Disorders

What Is a Voice Disorder?

It is easy to take our voices for granted until an inability to use our voice interferes with communication in our day to day lives. Initially, one may experience only intermittent hoarseness or discomfort in the throat area. This may subside with voice rest or decreased voice use. However, when hoarseness continues for more than two weeks without explanation, a team of voice care professionals should evaluate it.

A voice disorder may range from a mere annoyance where one cannot communicate with family members and friends in social situations or it may have devastating effects upon our lives when one prevents us from performing the demands of our professional work. The school teacher who becomes hoarse after a day of teaching, the airline reservation agent who cannot answer the telephone, the minister who cannot deliver a Sunday sermon or the singer who cannot perform at a professional engagement all feel the impact of a voice disorder in a significant way. In these cases, a voice disorder can actually have an economic impact, as well. Left untreated, there may psychological, social and serious professional consequences.

What Causes Voice Disorders?

There are many causes of voice problems and usually the cause is multifactorial. It may be the result of overuse, talking too loudly or for too long. Sometimes they occur following an upper respiratory infection; the infection may be gone, but one's voice just has not returned to normal. Speaking at an inappropriate pitch, whether too high or too low may also cause vocal fatigue and hoarseness. Other contributory factors include improper breathing, chronic throat clearing and coughing, excessive dryness due to poor fluid intake or side effects of certain medications, or smoking. Hoarseness may also be a sign of other medical problems, including Gastroesophageal Reflux Disease, psychological stress, laryngeal cancer, hormonal changes and more serious neurological problems.

What Are Some Signs of a Voice Disorder?

Symptoms of a voice disorder may include any of the following:

  • Hoarseness, roughness, raspiness
  • Breathiness or feeling short of breath
  • Voice cuts off for no reason
  • Tickle in the throat or urge to cough
  • Loss of vocal control, such as an inability to vary loudness or softness
  • Dull ache / pain in the throat area, or a feeling of a "lump" in the throat
  • Chronic throat clearing or coughing
  • Change in the pitch of the voice
  • Loss of vocal range, i.e. decreased access to high or low pitches
  • Vocal fatigue or increased effort to speak / sing
  • Heartburn
  • Bitter / acidic taste in the mouth

Who Is Likely to Have a Voice Disorder?

Anyone can have a voice disorder; sometimes the cause is not even identifiable. These are commonly called voice disorders of unknown etiology. Occupational voice users and professional voice users have an increased incidence of voice problems, just because they use their voices on a daily basis and cannot tolerate as easily some of the small variations in voice quality that others may ignore.

What Is The Prevalence of Voice Disorders?

Results of various studies vary, but in children up to the age of 14 years, the prevalence of voice disorders is about 6 in 100, or 6% (Leske, 1981 and Marge, et al., 1985). This apparently decreases during adulthood, ages 15 to 44, where the incidence is reported to be as low as 1% of the population, increasing to 6.5% in those 45 to 70 years old. It is our belief that these numbers for the adult population are low and that many voice disorders, such as mild hoarseness or breathiness go untreated or even unnoticed for years.