What is a Voice Disorder?

Our voice is produced when air from the lungs passes through the vocal cords in the larynx (voice box) causing the vocal cords to vibrate. This vibration produces a sound that is then modified and shaped by the vocal tract (throat, mouth and nasal passages). A voice problem or disorder can be caused by a problem in any part, or combination of parts, of this system.

Symptoms of a voice disorder can include:

  • hoarseness
  • roughness
  • breathiness
  • strained voice
  • weak voice
  • vocal fatigue
  • throat pain when speaking

The causes of these symptoms are many and can include:

Assessment

Assessment of voice includes taking a detailed history of the problem, collecting acoustic and aerodynamic measures, and looking at vocal cord function using laryngeal videostroboscopy (a scope that goes in the mouth and looks down at the vocal cords). This information allows us to determine what is causing the voice problem and recommend appropriate treatment. It is usually necessary to see an otolaryngologist (ear, nose, and throat doctor) to determine any medical causes of the voice problem.

Treatment

Voice therapy can be very effective in reducing or eliminating a voice disorder, depending on the cause of the voice disorder. Voice therapy often includes improving vocal hygiene (adequate hydration, reducing misuse/overuse, etc.) as well as direct therapy methods aimed at changing inefficient and/or inappropriate vocal patterns. For example, muscle tension frequently causes a person to use too much effort when speaking. Teaching a person to produce voice without excessive tension can reduce or eliminate vocal fatigue, hoarseness, breathiness, and vocal nodules along with other symptoms. Sometimes concurrent medical treatment is also necessary, or medical care alone is the most appropriate treatment.

Some of the therapy approaches used in our clinic include (this is not an all-inclusive list):

  • Resonant Voice Therapy (RV) - There are several approaches to RV, including Lessac-Madsen Resonant Voice Therapy (LMRVT)
  • Flow Resistent Tube (FRT) - A type of therapy using a semi-occluded vocal tract (SOVT); often called straw phonation. Click HERE to go to a YouTube video of Dr. Ingo Titze, Director of the National Center of Voice and Speech, demonstrating straw phonation.
  • Vocal Function Exercises (VFE) - A structured set of 4 exercises that work to balance breath support, easy voicing, and resonance. Click HERE to see a YouTube video of Dr. Joe Stemple, the developer of VFEs, demonstrating the exercises.
  • Lee Silverman Voice Therapy (LSVT) - A well-researched therapy designed to address soft voice and decreased intelligibility in people with Parkinson's disease.

Associated Faculty

Martin Nevdahl, MS, CCC-SLP - Senior Lecturer & Clinical Supervisor, Voice Unit Coordinator
Mara Kapsner-Smith, MS, CCC-SLP - Lecturer & Clinical Supervisor
Tanya Eadie, PhD, CCC-SLP - Professor & Researcher
Albert L Merati, MD - Professor & Chief of Larynogology, UWMC; Adjunct Professor, Speech & Hearing Sciences

Additional Resources

American Speech-Language-Hearing Association (ASHA)

The Voice Foundation

Northwest Parkinson's Foundation

The National Spasmodic Dysphonia Association (NSDA)