Voice Disorders


Accoring to world Health Organisation persistant change of voice for more than 3weeks should be immediately attended to exclude throat (vocal Cord) cancer

Many people in the society with voice problems move desperately thinking that they have no solution for their problem Most of these problems can be prevented by Voice Hygiene techniques. When voice problem occurs in professional Users like singers, teachers lawyers, politicians, business it may endanger their livelihood. Such people can be treated perfectly in voice clinics.

People with voice disorders have very typical complaints, which include :

  • Hoarseness
  • Scratchy voice, weak voice, breathy voice.
  • Difficulty with loudness, increased effort to talk.
  • Pain or discomfort while speaking or singing.
  • Change in singing voice.
  • Voice fatigue (worsening voice quality or discomfort with voice use) .
  • Changes in voice after trauma or surgery to the neck, throat, or larynx.
  • Change in pitch of the voice,Female voice in males (puberphonia) or male voice, in females (andrpohonia) .
  • Hyper and hyponasality (Nasal voice).

What are the causes of voice disorders ? Voice disorders can be caused by a variety of factors such as :

  • Organic Voice Disorders
  • Congential (Defects by birth
  • Sulcus Vocalis, Vocal Folda webs etc.,
  • Thyroplasty Type - IV

How is a voice disorder diagnosed?

A thorough evaluation of the patient is required to diagnose the patient’s problem and to decide its management. A typical evaluation normally includes:

  1. A thorough history taking, to determine the exact nature and possible causes of the complaint
  2. Assessing the function  of the vocal folds with Flexible Laryngoscope .
  3. Examining the vocal cords using a specialized flickering light source, called digital Laryngostroboscopy. This allows an assessment of the movement and vibration of the vocal cords.This the best & latest instument for early detection of vocal cord cancer.
  4. Analysis of the sound signal (acoustic  orComputerized voice analysis).
  5. Analysis of airflow and air pressure during voice production (aerodynamic assessment).
  6. Evaluation of muscle tone in the muscles used to produce voice (electromyography)
  7. Evaluation of the nasal cavity, palatal region, nasopharynx and oropharynx are carried out with the help of a flexible fibreoptic nasopharyngoscope.
  8. Discussion of difficult cases with international faculty

Other special tests may also be required for a complete evaluation of the voice disorder. Many times a voice problem has to be diagnosed and treated by a team of specialist like E.N.T Surgeon Voice therapist, gastroenterologist, endocrinologist, neurophysician and psychologist etc.. How the Voice problems can be prevented?

  1. Avoiding Abuse or misuse of voice like yelling.
  2. Drinking sufficient water.
  3. Avoiding throat clearing.
  4. Avoiding spicy foods.
  5. Avoiding drugs like aspirin or anti allergic drugs.
  6. Avoiding of smoking an alcohol.
Various Treatment modalities in the management of voice problems

After the patient's voice disorder has been diagnosed, various treatment options are offered to the patient by the voice surgeon and the voice therapist. These might include pharmacotherapy, voice therapy and phonosurgery.

How Voice Problems can be corrected? Voice problems can be corrected in two ways

1. By voice therapy 
2. By voice surgery or phonosurgery


The term "phonosurgery" refers to any surgical procedure, performed with an aim to improve the voice. . There are different surgical procedures available at the clinic for the treatment of voice disorders. These include, laryngeal framework surgery and Phonomicrosurgery and Flexible Endoscopic Laryngeal surgery.

Phonomicrosurgery is performed with good effect for various laryngeal pathologies. These include:

Pathological lesions like : -

vocal nodules, polyps, vocal cord cysts, papillomas, angiomatous lesions and Reinke's oedema.
- recessed lesions like sulcus vocalis
- leucoplakia and intramucosal cysts

Malignancy. effective treatment for early stages of laryngeal cancer.

- Phonomicro surgery is an excellent method in the treatment of Singers 

Laryngeal framework surgery:

Thyroplasty: This is a technique where the function of the vocal cords can be modified by changing their position and tension, without actually opening the larynx. There are four types:

  1. Type I : One vocal cord is pushed towards the other cord (medialised), by inserting a graft or implant into the tissue of the vocal fold through the corresponding side of the thyroid cartilage.Useful in hoarsevoice due to
  2. Single vocal cord paralysis mostly after thyroid operations
  3. Conditions leading to incomplete closure of the vocal cords are the main indications for this kind of a procedure.
  4. Type II: Here, the anterior part of the thyroid cartilage is cut vertically and a silicon implant of suitable size is inserted, so as to move the vocal cords away from each other (lateralization). 
    This procedure is useful in the treatment of such disorders as spasmodic dysphonias and paralysis of both vocal cords.
  5. Type III and IV thyroplasty are procedures which shorten or lengthen the vocal folds respectively and are used to change the pitch of the voice.It is a useful method In correcting female voice in males or in male voice in females
The interesting part these surgeries is as these procedures are done under Local Anesthesia the The patient can talk during the operation and also find improvement voice instantenesly

For further information consultation:
Dr.V.Phaniendrakumar M.S.,F.I.A.O., 
E.N.T & Voice Surgeon, Member of Voice Foundation, U.S.A 
President of Association of Voice surgeons of India 
Melody Voice Clinic,Himayathnagar, Hyderabad 
For appointment Call: +91 40 66613901 / 65408424
For details Mobile : 9848134018
E mail : drvoicep@hotmail.com 

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