Voice disorders are conditions involving abnormal pitch, loudness or quality of the voice, thereby affecting speech production. A voice disorder describes differences in voice that are inappropriate for an individual’s age, gender, cultural background, or geographic location. A person has a voice disorder if they express concern about having an abnormal voice that does not meet their daily needs. Even in the case where others cannot perceive the difference. Voice disorders are classified in a number of ways.
Most simply, voice disorders can be considered in three categories:
Organic voice disorders are physiological in nature and occur when there is a change to respiratory, laryngeal, or vocal tract mechanisms within a person’s body. There are two types of organic voice disorders: Structural and Neurogenic.
- Structural voice disorders are caused by physical changes to the voice mechanism such as vocal nodules and oedema where the vocal fold tissue is altered by misuse or structural changes to the larynx that happen as a part of aging.
- Neurogenic voice disorders are caused by dysfunction of the central or peripheral nervous system innervating the larynx, which in turn affects functioning of the vocal mechanism. This includes voice changes such as tremors caused through Neurogenic diseases such as Parkinson’s disease, paralysis of one or both of the vocal folds or involuntary movements known as spasmodic dysphonia.
A functional voice disorder is caused by the improper or inefficient use of the vocal mechanism. This is despite there being no abnormalities to the physical structures involves in voicing. Functional voice disorders can be caused by the presence of an organic disorder that leads to habitual, mal-adaptive vocal habits. Even after the organic change or long standing vocal habits have been treated. Some examples of functional voice disorders include vocal fatigue, muscle tension dysphonia, diplophonia and ventricular phonation.
A psychogenic voice disorder occurs when there is no structural reason for the voice disorder. There may or may not be patterns of muscle tension (functional voice disorder) and the primary cause is psychological. While psychogenic components within voice disorder do occur, voice disorders caused by a psychological disorder are relatively rare. These individuals may benefit more from a referral to appropriate professionals other than speech pathologist such as psychologist or psychiatrist for treatment.
Most voice disorders fall into the first two categories and overlap is very common. One of the most common cases is when an individual has a functional disorder. This is where they habitually misuse their voice, and this leads to a vocal trauma. Eventually this can lead to an organic disorder such as vocal nodules. It is important to determine the correct diagnosis and cause for voice disorders. Treatment will differ depending on the type and cause.
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This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns.
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• Martins RH, do Amaral HA, Tavares EL, Martins MG, Gonçalves TM, Dias NH. Voice Disorders: Etiology and Diagnosis. J Voice. 2016 Nov;30(6):761.e1-761.e9. pubmed link