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Description
As everyone's voice is unique it is difficult to
define a normal voice. A normal voice is pleasant sounding and has age and sex
appropriate pitch and loudness. When a voice is not pleasant sounding, is too
loud or too soft or is too high or low for one's gender, a voice problem may
be present.
Voice disorder are divided into 2 categories:
organic voice disorders and functional voice disorders. Organic voice
disorders stem from disease or pathology. They require medical intervention.
Functional voice disorders result from abuse or misuse of the voice. They can
often be managed by voice therapy.
Voice is produced when the vocal folds (often
called vocal cords) come close together and air from the lungs sets them
vibrating in a regular fashion. The vibration causes a series of pulses which
in turn causes the air column in the vocal tract to resonate and produce
voiced sound.
When we are breathing, our vocal folds are open
(abducted), and air passes by without vibrating them. Some sounds (e.g., s,
sh, f) are produced without voice. When the vocal folds are brought together
(adducted), the air pushes against the small opening and makes them vibrate,
producing voicing. All vowels and some consonants (e.g., z, v, g) are voiced.
Put your hand on your neck over your adam's apple. Say "aaaahhh" and feel the
vibration in your voice box. Say a long "sssss": there should be no vibration.
Organic voice disorders include cancer, vocal fold
paralysis, endocrine changes, granuloma, hemangioma, papilloma and laryngeal
web.
Functional voice disorders arise when the voice is
used improperly. Misuse of the voice includes talking too much or too loudly,
yelling, or using an unnatural pitch (faking a deep or high voice). Abuse
occurs with nonverbal vocal behavior such as excessive throat clearing,
laughing, crying, coughing and smoking. Misuse and abuse can cause
physiological changes to the vocal folds, creating vocal nodules, polyps,
contact ulcers and edema. In the case of yelling, the vocal folds come
together in a hard way. As they bang together again and again, swelling can
occur, and eventually a blister can form.When the vocal folds are swollen or
have a nodule/polyp, they can't come together as closely as they normally do.
There is a chink or hole through which the air from the lungs can whistle
through. The vocal folds vibrate in an irregular fashion. The result is a
hoarse sounding voice.
Therapy for functional disorders involves
identifying abuses and misuses and reducing or eliminating them. Individuals
sometimes need help "finding" their old voice if the disorder has been
longstanding. It is important to rule out an organic basis before starting
voice therapy. A referral to an ENT (ear, nose, and throat
doctor/otolaryngologist) is necessary to rule out an organic voice disorder.
Internet Links
Teachers...take care of your voice
http://www.nidcd.nih.gov/health/education/news/teachers.asp
Information and commonly asked questions about
vocal nodules.
http://webpages.marshall.edu/~white61/vocal.html
About voice disorders in children.
http://www.cslot.com/children/child_voice_disorders.htm
Information for parents about pediatric voice
disorders.
http://www.voiceproblem.org/disorders/pediatricdisorders/diagnosis.asp
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