Hoarseness / Dysphonia

Causes of Dysphonia

All dysphonia is an interruption in the ability of the vocal folds to vibrate normally during exhalation.

During normal phonation, the vocal folds come together to vibrate in a simple, open/closed cycle, altering the airflow from the lungs. One can think of vocal cords as bowstrings that vibrate with varying lengths and tensions to produce certain pitches and sounds. Louder sounds are produced by increasing the airflow volume of the vocal cords themselves.

Weakness (paresis) or complete lack of movement (paralysis) of one vocal cord or side of the larynx can prevent cyclic vibration and lead to irregular movement in one or both sides of the voice box. This irregular motion sounds like roughness.

Types of Dyphonia

Dysphonia has one of two types of causes: organic or functional

Organic Dysphonia

Organic dysphonia is due to an outside cause affecting the function of the larynx.

Causes of Organic Dysphonia:

• Laryngitis
• Vocal cord nodules, polyps, or cysts
• Reinke’s Edema (mostly caused by smoking)
• Neoplasm
• Trauma
• A few other rare disorders

Functional Dysphonia

Functional dysphonia is behavioral, occurring when voicing or compensatory behavior alters normal voice function.

Causes of Functional Dysphonia:

• Psychogenic
• Vocal abuse or misuse
• Idiopathic

Diagnosis of Dysphonia

Dysphonia is measured using a variety of examination tools (particularly laryngeal videostroboscopy) that allow the clinician to see the pattern of vibration of the vocal folds.

Flexible laryngoscopy is sometimes used as the first step to rule out malignancy or any mass effect on the vocal cords.