There
are variety of medical conditions that can lead to voice problems. The most
common causes are hoarseness and vocal difficulties. If you become hoarse
frequently or notice voice change for an extended period of time, please see
your Otolaryngologist (Ear, Nose, and Throat doctor) for an evaluation.
Medical
Conditions That Can Cause Voice Problems - After The American Academy of
Otolaryngology – Head and Neck Surgery http://www.entnet.org/
ACUTE
LARYNGITIS
Acute
laryngitis is the most common cause of hoarseness and voice loss that starts
suddenly. Most cases of acute laryngitis are caused by a viral infection that
leads to swelling of the vocal cords. When the vocal cords swell, they vibrate
differently, leading to hoarseness. The best treatment for this condition is to
stay well hydrated and to rest or reduce your voice use. Serious injury to the
vocal cords can result from strenuous voice use during an episode of acute
laryngitis. Since most acute laryngitis is caused by a virus, antibiotics are
not effective. Bacterial infections of the larynx are much rarer and often are
associated with difficulty breathing. Any problems breathing during an illness
warrants emergency evaluation.
CHRONIC
LARYNGITIS
Chronic
laryngitis is a non-specific term and an underlying cause should be identified.
Chronic laryngitis can be caused by acid reflux disease, by exposure to
irritating substances such as smoke, and by low grade infections such as yeast
infections of the vocal cords in people using inhalers for asthma. Chemotherapy
patients or others whose immune system is not working well can get these
infections too.
LARYNGOPHARYNGEAL
REFLUX DISEASE (LPRD)
Reflux
of stomach juice into the throat can cause a variety of symptoms in the
esophagus (swallowing tube) as well as in the throat. Hoarseness (chronic or
intermittent), swallowing problems, a lump in the throat sensation, or throat
pain are common symptoms of stomach acid irritation of the throat. Please be
aware that LPRD can occur without any symptoms of frank heartburn and regurgitation
that traditionally accompany gastro esophageal reflux disease (GERD).
VOICE
MISUSE AND OVERUSE
Speaking
is a physical task that requires coordination of breathing with the use of
several muscle groups. It should come as no surprise that, just like in any
other physical task, there are efficient and inefficient ways of using your
voice. Excessively loud, prolonged, and/or inefficient voice use can lead to
vocal difficulties, just like improper lifting can lead to back injuries.
Excessive tensionin the neck and laryngeal muscles, along with poor breathing
technique during speech leads to vocal fatigue, increased vocal effort, and
hoarseness. Voice misuse and overuse puts you at risk for developing benign
vocal cord lesions (see below) or a vocal cord hemorrhage.
Common
situations that are associated with voice misuse:
Speaking
in noisy situations
Excessive
cellular phone use
Telephone
use with the handset cradled to the shoulder
Using
inappropriate pitch (too high or too low) when speaking
Not
using amplification when publicly speaking
BENIGN
VOCAL CORD LESIONS
Benign
non-cancerous growths on the vocal cords are most often caused by voice misuse
or overuse, which causes trauma to the vocal cords. These lesions (or bumps) on
the vocal cord(s) alter vocal cord vibration and lead to hoarseness. The most
common vocal cord lesions are nodules, polyps, and cysts. Vocal nodules (also
known as nodes or singers’ nodes) are similar to calluses of the vocal cords.
They occur on both vocal cords opposite each other at the point of maximal wear
and tear, and are usually treated with voice therapy to eliminate the vocal
trauma that is causing them. Contrary to common myth, vocal nodules are highly
treatable and intervention leads to improvement in most cases. Vocal cord
polyps and cysts are the other common benign lesions. These are sometimes
related to voice misuse or overuse, but can also occur in people who don’t use
their voice improperly. These types of problems typically require microsurgical
treatment for cure, with voice therapy employed in a combined treatment
approach in some cases.
VOCAL
CORD HEMORRHAGE
If
you experience sudden loss of voice following yelling, shouting, or other
strenuous vocal tasks, you may have developed a vocal cord hemorrhage. Vocal
cord hemorrhage results when one of the blood vessels on the surface of the
vocal cord ruptures and the soft tissues of the vocal cord fill with blood. It
is considered a vocal emergency and is treated with absolute voice rest until
the hemorrhage resolves. If you lose your voice after strenuous voice use, see
your Otolaryngologist as soon as possible.
VOCAL
CORD PARALYSIS AND PARESIS
Hoarseness
and other problems can occur related to problems between the nerves and muscles
within the voice box or larynx. The most common neurological condition that
affects the larynx is a paralysis or weakness of one or both vocal cords.
Involvement of both vocal cords is rareand is usually manifested by noisy
breathing or difficulty getting enough air while breathing or talking. When one
vocal cord is paralyzed or weak, voice is usually the problem rather than
breathing. One vocal cord can become paralyzed or weakened (paresis) from a
viral infection of the throat, after surgery in the neck or chest, from a tumor
or growth along the laryngeal nerves, or for unknown reasons. Vocal cord
paralysis typically presents with a soft and breathy voice. Many cases of vocal
cord paralysis will recover within several months. In some cases however, the
paralysis will be permanent, and may require active treatment to improve the
voice. Treatment choice depends on the nature of the vocal cord paralysis, the
degree of vocal impairment, and the patient’s vocal needs. While we are not
able to make paralyzed vocal cords move again, there are good treatment options
for improving the voice. One option includes surgery for unilateral vocal cord
paralysis that repositions the vocal cord to improve contact and vibration of
the paralyzed vocal cord with the non-paralyzed vocal cord. There are a variety
of surgical techniques used to accomplish this. Voice therapy may be used
before or after surgical treatment of the paralyzed vocal cords, or it can also
be used as the sole treatment. (For more information, see Vocal Cord Paralysis
Fact Sheet.)
LARYNGEAL
CANCER
Throat
cancer is a very serious condition requiring immediate medical attention.
Chronic hoarseness warrants evaluation by an otolaryngologist to rule out
laryngeal cancer. It is important to remember that prompt attention to changes
in the voice facilitate early diagnosis. Remember to listen to your voice
because it might be telling you something. Laryngeal cancer is highly curable
if diagnosed in its early stages. (For more information, see Laryngeal Cancer
Fact Sheet.)
A
list of Medical Conditions That Cause Voice Problems are from
Check
also my other posts on voice:
Voice
Hygiene
Voice
Disorders
