Read about Dysphonia Types, Symptoms, Causes, Treatment. Muscle tension dysphonia, functional dysphonia and spasmodic dysphonia. dysphonia vs dysarthria.
The generation of voice requires a sound producing system called as phonatory system, a control center and a network connecting the two.
- Phonatory system includes voice box and vocal cords
- Control center consist of brain
- Network connecting phonatory system and control center consist of 10th cranial nerve and its branches
Dysphonia is a descriptive medical terminology meaning disorder (dys) of voice (phonia). It is impairment in the ability to produce voice sounds using the vocal organs. It is distinct from dysarthria which signifies dysfunction in the muscles needed to produce speech. Thus, dysphonia is a phonation disorder. The dysphonic voice can be hoarse or excessively breathy, harsh, or rough, but some kind of phonation is still possible in contrast with the more severe aphonia where phonation is impossible.
Dysphonia Types, Symptoms, Causes, Treatment
Let’s review about Dysphonia Types, Symptoms, Causes, Treatment.
Types of Dysphonia
There are two general categories or types of dysphonia.
The organic type includes situations where there is some sort of impediment to the function of the vocal cords, such as an infection or damage to the chords as the result of an accident. Organic voice disorders fall into two groups:
Structural disorders involve something physically wrong with the mechanism, often involving tissue or fluids of the vocal folds. Neurogenic disorders are caused by a problem in the nervous system.
Organic dysphonia may occur due to
- Laryngitis (Acute: viral, bacterial) – (Chronic: smoking, GERD, LPR)
- Neoplasm (Premalignant: dysplasia) – (Malignant: Squamous cell carcinoma)
- Trauma (Iatrogenic: surgery, intubation) – (Accidental: blunt, penetrating, thermal)
- Endocrine (Hypothyroidism, hypogonadism)
- Hematological (Amyloidosis)
- Iatrogenic (inhaled corticosteroids)
Functional dysphonia involves situations where there is some type of psychogenic component, or perhaps a misuse of the vocal cords that leads to a temporary problem with the voice. It may be
- Vocal misuse
Symptoms of Dysphonia
Individuals with dysphonia may present with hoarseness and a sore or dry throat. A vocalist may see that he or she is no longer able to sing in the upper range. There may be other related symptoms, for example,
- A continuous dribble at the back of the throat (nasal catarrh)
- Acid reflux or heart burn
- Difficulty in swallowing
- Loss of appetite
- Coughing up blood
- Loss of weight
Causes of Dysphonia
- Congenital – e.g. laryngeal web, laryngomalacia, congenital cyst
- Vocal cord nodules
- Voice overuse
- Gastro-oesophageal reflux,
- Malignancy in rare conditions
- Inflammation of the larynx (voice box) over a short (acute) or long (chronic) period of time.
- Lumps (nodules) on the vocal cords (e.g. singer’s nodules).
- Underactive thyroid gland – hypothyroidism.
- Trauma – any kind of trauma, including surgery, to the vocal cords will inevitably cause scarring and hence affect the vocal fold function. The risk of permanent voice change therefore needs to be discussed prior to surgery on the larynx.
- Vocal cord paralysis – some other surgical operations including removal of the thyroid gland and heart or lung surgery can damage the nerves to the larynx causing either temporary or permanent vocal cord paralysis (palsy).
- Reinke’s edema of the larynx.
- Psychological voice changes are common when people are under stress either at work or at home. The voice may be lost suddenly, usually overnight or following a cold. It is important to identify and remove the underlying stress. Speech therapy is very useful for this cause.
Treatment of Dysphonia
Any individual who has been hoarse for four weeks or more should look for medicinal consideration from physician. Every condition has its own particular treatment, and the treatment ought to likewise be perfectly customized to every person. The general standards of treatment management are depicted below:
Each endeavor ought to be made to recognize and wipe out causative components, for example, stress, smoking, and alcohol Drink a lot of clear fluid to maintain a strategic distance from a dry throat. Rest the voice totally for a few days. No talking or whispering is permitted. Communicate to others by recording everything on a notebook.
The speech therapist plays an important role in the assessment and treatment of patients with voice disorders, e.g. Reinke’s edema, vocal cord nodules and voice misuse. The treatment will take a few weeks or months before any improvements are seen thus the patient must be highly energetic and motivated.
Bed rest, regular paracetamol and saline or soluble aspirin gargles are often adequate. Antibiotics are only indicated when there is bacterial infection. Nasal sprays such as Beconase are used to treat patients who suffer from chronic inflammation of the sinuses and nasal lining and who get catarrh dripping down the back of the throat. Medications to reduce acid secretion by the stomach are used to treat patients with gastro-oesophageal reflux.
Surgery is indicated for
- Diagnosis (e.g. tissue biopsies)
- Treatment (e.g. removal of tumors and laser surgery)
The operation is performed with a fibre-optic viewing ‘telescope’ (endoscope) under general anesthesia. The view of the larynx is magnified with a microscope so that delicate operations can be carried out. The procedure is known as micro laryngoscopy or endolaryngeal microsurgery. Surgical management of non-cancerous causes of voice disorders is only indicated when all the other measures have failed.