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Common Voice Problems

Hoarseness or other difficulties with talking may occur for many reasons and can be treated with medical and surgical therapies. One of the most important aspects of treating hoarseness (or other changes in voice) is following good habits to prevent voice and throat problems. In addition to treatment prescribed by the physician, it is important to follow these guidelines. Some of these suggestions may be recommended to help patients with sore throats, chronic cough or other upper respiratory ailments.

Generally speaking, though, problems that affect the voice can be divided into infectious and non-infectious. The non-infectious usually predominate.

Non-infectious conditions that affect the voice:

  1. Vocal abuse: swelling of the true vocal folds (TVF’s) from yelling, screaming, singing incorrectly
  2. Muscle Tension Dysphonia: a “tight larynx”; increased muscle tension in the larynx and neck that may arise for a variety of reasons. Can lead to TVF nodules.
  3. Gastroesophageal (Laryngopharyngeal) Reflux Disease: the reflux of stomach acid and contents up into the back of the throat where it comes into contact with the delicate tissue of the larynx (voice box). This causes the tissues to swell, become inflamed, and is one of the most common contributors to hoarseness.
  4. Paralysis or weakness of the TVF’s: this can occur as a result of surgery or due to a viral infection.
  5. Spasmodic Dysphonia – a rare condition in which the intrinsic muscles of the larynx spasm, creating “catches” or voice breaks while speaking
  6. Neurologic diseases such as amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis (MS), myasthenia gravis, etc.
  7. Contact ulcers and granulomas – both due to a minor injury to the mucosa of the larynx, such as might occur with intubation for surgery (placement of a tube for breathing during surgery), coughing, reflux, viral infections etc.

Infectious conditions that affect the voice

  1. Viral laryngitis – very common; usually associated with upper respiratory tract infection symptoms (fever, malaise, hoarseness, cough, etc).
  2. Herpes Simplex – painful ulcers on the larynx
  3. Bacterial Supraglottitis – usually due to Staph, H. flu, or Strep. Can be life-threatening, especially in children.
  4. Candida (yeast) – sometimes seen in patients with asthma who use a steroid inhaler and don’t gargle after each application. Can be seen in people who are immunocompromised.
  5. Angioedema – a potentially life-threatening condition in which the small vessels of the larynx suddenly become leaky due to a sudden inflammatory reaction.