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Voice Disorders
What is a voice disorder?

A voice disorder is any abnormality of the voice production system that results in a change in your voice that is unsatisfactory to you. You may experience numerous symptoms, or perhaps there is only one symptom that bothers you. The symptoms may be persistent or you may experience them only intermittently. Your symptoms may include:

  • Hoarseness or other change in the pitch, timbre or quality of your voice
  • Vocal fatigue
  • Loss of a portion of your speaking or singing range Difficulty with register transitions of the speaking or singing voice
  • Discomfort or burning sensation in the throat
  • Sensation of ?something? in your throat
  • Difficulty making the voice sufficiently loud or soft
  • Breathlessness when you speak
  • Tremor quality or abrupt starts and stops of your voice that you have difficulty controlling
  • Feeling the need to cough or clear your throat frequently
  • Tightness, discomfort or a burning sensation in the throat

What causes voice disorders?

There are numerous different causes of voice disorders, and different types of voice disorders have similar symptoms. Rarely do voice problems occur overnight. More commonly, they are the result of lifestyle choices? occupational or social vocal demands ? often combined with health problems or other personal factors. There are some groups of people who are particularly at risk for developing a voice disorder because of certain features about their job, health or living habits.

When should I see a physician about my voice?

You should see a physician if you experience:

  • Voice changes lasting longer than two weeks, especially if you smoke
  • Pain in your throat when talking that is not from a cold or flu
  • Severe change in your voice, or complete loss of voice lasting longer than a few days and is not associated with a cold or flu
  • Persistent voice changes that inhibit your ability to do your normal activities
  • Smokers should not hesitate to see a physician with any change in their voice. Smoking causes throat cancer, and hoarseness is one of its earliest signs.

What type of physician should I see about my voice problem?

At a minimum, you should visit a board-certified otolaryngologist (Ear, Nose and Throat physician). Otolaryngologists who specialize exclusively in voice problems are called laryngologists. In order to best determine whether there are any abnormalities on the vocal folds, your visit should include an endoscopic examination, preferably a videostrobscopy exam, which provides ?stop action? video of vocal fold vibration. If you are a performer, you should visit a laryngologist who is familiar with the vocal requirements of performers.

Why has The Voice and Swallowing Institute been established at New York Eye and Ear Infirmary for the treatment of voice disorders?

Medical and scientific understanding of how voice problems occur and how they are best treated is changing rapidly as increasingly sophisticated diagnostic and treatment techniques become available. The explosion in knowledge about normal and abnormal voice production, diagnostic and treatment approaches has made it almost impossible for one single individual to know everything that needs to be known about voice problems. At The Voice and Swallowing Institute, our treatment team includes a laryngologist and voice therapist, among others, to provide you with the best and most current clinical care.

What can I expect during my visit?

When you arrive for your appointment, you will need to complete registration forms, including insurance referral information that may be necessary for your particular plan. Then, you will be asked to complete a short questionnaire about the symptoms you may be experiencing. You will participate in an in-depth interview with the team regarding your health, your voice, and your lifestyle. We need to get to know you ? your profession, your personality, even your hobbies can all affect your voice! Your visit will probably include a laryngeal videostroboscopy examination. This is an examination of the larynx using an oral endoscope connected to a digital video camera. This is not painful at all. Topical anesthetic may be sprayed at the back of the mouth to make the exam more comfortable. Vocal function testing may also be performed, including asking you to produce a variety of words and sounds, modified in different ways, to test different aspects of voice. We will discuss our findings and treatment recommendations with you at the time of the initial evaluation. You will be given the time and opportunity to ask questions and raise any concerns you may have. You will leave your appointment with information about your diagnosis and a plan for treatment or any further testing that may be necessary.

Will I probably need surgery to cure my voice problem?

It depends upon the cause of the voice problem, of course. For a few types of voice problems, surgery is the best treatment. But for many types of voice problems, surgery is not the first treatment, and for some types of problems, surgery is not recommended at all. Voice disorders may be treated with various medicines, and often with voice therapy (a behavioral approach), sometimes by itself, and sometimes before or after surgery. If there are multiple treatments, we will offer you all if the information needed to make an intelligent choice. Treatment plans are complex decisions based upon many factors. The most important of these is each person?s vocal needs. Every patient at The Voice and Swallowing Institute participates in decision-making about his or her treatment in partnership with the Institute?s team.

This information has been prepared by Lucian Sulica, M.D. and Alison Behrman, PhD CCC-SLP. For more information these and other topics related to voice disorders, visit The Voice and Swallowing Institute website, or call us at (212) 979-4200.

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