Voice & Swallowing Problems

Dysphonia refers to a group of voice disorders that affect the quality, pitch, loudness, or resonance of the voice. It can result from various underlying causes and may present with different symptoms.

Functional causes may range from vocal misuse or abuse, vocal nodules, polyps, or cysts (benign growths on the vocal cords due to vocal strain) or muscle tension dysphonia where vocal cord function is affected due to excessive tension in the muscles surrounding the larynx.

Neurological causes could be vocal cord paralysis or paresis (damage or dysfunction of the nerves controlling the vocal cords, affecting movement and position), Parkinson's disease, stroke, or other neurological conditions that can affect the muscles and nerves involved in voice production.

Structural causes involve laryngeal trauma or laryngeal cancer (tumours affecting vocal cords or surrounding structures) which is likely to affect smokers above the age of 40, although non-smokers may also get laryngeal cancer. Systemic causes would mean acid reflux (laryngopharyngeal reflux) when stomach acid irritates the tissues of the larynx; or autoimmune diseases like rheumatoid arthritis or systemic lupus erythematosus.

Viral laryngitis and Gastro-Oesophageal Reflux Disease (GORD) can also cause dysphonia.

Aside from changes in voice quality characterised by rough, raspy, or strained vocal sounds, individuals may also experience voice fatigue, difficulty in controlling pitch or speaking loudly, breathy or strained voice, and pain or discomfort, during or after speaking.

Behavioural and lifestyle changes like voice rest, hydration and avoiding irritants can help treat this laryngeal problem. Voice therapy and vocal hygiene education may also be recommended. The patient may be prescribed medication for conditions like acid reflux or inflammation of the larynx. Botulinum toxin injections may also be administered to treat spasmodic dysphonia. Surgical treatment may be required in extreme cases. For instance, laryngeal microsurgery can help remove vocal cord nodules, polyps, or cysts while laryngeal framework surgery can help with certain cases of vocal cord paralysis or structural abnormalities.