Hoarseness / Dysphonia
Dysphonia is any impairment in the vocal fold's ability to produce sounds and is usually benign. Learn about the causes and treatment options for Dysphonia or Hoarseness.
Dysphonia is defined as a voice that is hoarse, weak, excessively breathy, harsh, or rough, but some kind of phonation is still possible.
Aphonia occurs when phonation or voicing is impossible.
Causes of Dysphonia
All dysphonia is caused by some kind of 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 volume of airflow of the vocal cords themselves.
Weakness (paresis) or complete lack of movement (paralysis) of one vocal cord or one 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 is heard as roughness.
Types of Dyphonia
Dysphonia has one of two types of causes: organic or functional
Organic dysphonia is due to an outside cause affecting the function of the larynx.
Causes of Organic Dysphonia:
- Vocal cord nodules, polyps or cysts
- Reinke’s Edema (mostly caused by smoking)
- A few other rare disorders
Functional dysphonia occurs as the result of a behavior when voicing or when a compensatory behavior alters normal voice function.
Causes of Functional Dysphonia:
- Vocal abuse or misuse
Diagnosis of Dysphonia
Dysphonia is measured using a variety of examination tools that allow the clinician to see the pattern of vibration of the vocal folds, principally laryngeal videostroboscopy.
Flexible laryngoscopy is sometimes used as the first step to rule out malignancy or any mass effect on the vocal cords.