Voice Problems

Voice is the sound made by vocal cord vibration caused by air passing through the voice box (larynx) when we bring our vocal cords together. Our voice is very important for communication, socialization, work and entertainment.

Tips For Healthy Voices

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Vocal Cords: Introduction

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Vocal Cord Nodules: Overview

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Vocal Cord Polyps: Overview

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Vocal Cord Paralysis: Overview

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Many things can affect our voice quality.

  • Acute Laryngitis
    • Inflammation and swelling of the vocal cord mucosa
    • Usually viral
  • Chronic Laryngitis
  • Allergy
  • Reflux
  • Voice misuse
    • Excessively loud, prolonged or improper use of voice
  • Benign vocal cord lesions
    • Nodules, cysts, polyps, hemorrhage
  • Cancerous vocal cord lesions
  • Age related changes to voice
    • Men – Higher pitch voice
    • Women – Lower pitch voice
    • Reduced volume and projection of the voice
    • Reduced vocal endurance
    • Difficulty being heard in noisy situations
    • Tremor or shakiness in the voice

Many neurologic conditions can affect the larynx and cause voice problems

  • Hyperfunctional disorders
    • Muscle tension dysphonia
    • Essential tremor
    • Stuttering
  • Hypofunctional disorders
    • Central nervous system disorders
    • Parkinson’s Disease
    • Myasthenia gravis, ALS, Multiple Sclerosis
    • Poliomyelitis
    • Myopathies
    • Psychogenic
  • Spasmotic dysphonia
    • Idiopathic focal laryngeal dystonia
    • Breathy or halting speech breaks
  • Vocal cord weakness or paralysis (injury to nerve to larynx)
    • Trauma
    • Tumor
    • Surgery
    • Viral infection affecting the nerve to the larynx
    • Neurologic causes, stroke
    • Idiopathic – unknown cause

Laryngeal Cancer Risk Factors:

  • Tobacco use
  • Excessive alcohol use
  • Human papilloma virus
  • Gastroesophageal reflux

Laryngeal Cancer Signs and Symptoms include:

  • Progressive or persistent hoarseness
  • Difficulty swallowing
  • Persistent sore throat or pain with swallowing
  • Difficulty breathing
  • Ear pain
  • Lump in the neck
  • Spitting up blood
  • Anyone with these signs or symptoms should be evaluated by an Otolaryngologist (Ear, Nose and Throat Doctor)

Voice Disorder Evaluation:

  • Complete history and physical examination to obtain accurate diagnosis
  • Diagnostic testing if indicated:
    • Flexible fiberoptic laryngoscopy – done in the office
    • Direct laryngoscopy and biopsy – done in the operating room
    • Neck CT Scan or MRI

Voice Disorder Treatment Options Include:

  • Good voice hygiene
  • Maintain good overall fitness
  • Voice / Speech Therapy
  • Biopsy / Excision of vocal cord lesion

If you have Voice problems, please call (503) 257-3204 or request a visit online with us.


American Academy of Otolaryngology−Head and Neck Surgery. One Prince St., Alexandria, VA 22314-3357, 1-703-836-4444. 2012 AAO-HNS/AAO-HNSF
Flint, P. W., C. W. Cummings, et al. (2010). Cummings otolaryngology head & neck surgery. Philadelphia, PA, Mosby/Elsevier: 3 v. (xlii, 2963, cxciv p.).