What is dysphonia?

Dysphonia is the term used to refer to disorders of the voice. This may present as a hoarse, weak, breathy or strained voice, with or without pain or discomfort in the throat.

Causes of dysphonia include:
• Inflammation of the larynx (voice box) due to an infection or allergy
• Reflux, if stomach acid comes far enough up the oesophagus (gullet) and spills over onto the voice box.
• Lesions on the vocal cords – including vocal cord nodules and cysts
• Trauma to the vocal cords from injury or surgery.
• Weakness or paralysis of the vocal cords
• Stress – voice changes may occur due to stress either at work or at home.
• Other causes

What to do if you have a voice problem

• If you notice a problem with your voice that has not resolved after 2 weeks you should seek advice from your GP.
• Your GP may be able to treat your voice problem. Otherwise they can refer you for specialist investigation and treatment.
• At the NNUH, all patients with a voice problem will be seen by an ENT (Ear, Nose and Throat) specialist first. The doctor will discuss your symptoms with you, and may use a flexible camera to look at your larynx (voice box).
• You may then be treated by ENT, and/or referred to Speech and Language Therapy for further management, if necessary.
• All patients referred to Speech and Language Therapy are seen in an assessment clinic first before being allocated to one of the voice therapy clinics, if this is still needed.

Tips for keeping your voice healthy

• Drink enough water – 6-8 glasses a day will help keep your vocal cords (vocal cords) moist. This helps them work more efficiently and makes them less vulnerable to damage.
• Steam inhalations (plain hot water with no menthol) moisten the vocal cords and thin out any sticky mucous that may have developed.
• Voice rest – especially if you have laryngitis or a throat infection.
• Breathing. Good voice depends on good breath support. Try not to talk too much, or push your voice, while you are out of breath, as this can strain the voice.
• Posture. Good posture helps you make the most of the spaces in your throat where your voice resonates. Poor posture can affect the alignment of your back and neck, which can distort the resonance spaces.
• Relaxation. Stress can cause muscle tension in the throat, leading to tightness, discomfort and voice changes. Pilates, Tai Chi and other types of gentle exercise can help reduce muscle tension.
• Stop smoking. Tobacco smoke irritates the vocal cords and dries them out. If you are a smoker, then consider stopping or cutting down for your general and vocal health.

How Speech and Language Therapy can help

Some causes of dysphonia will need surgery, but many can be treated with specialist voice therapy. Outpatient voice clinics are run regularly at the hospital and therapists can offer advice, support and exercises to help you improve your voice. ENT consultants and Speech and Language therapists also carry out joint clinics for complex voice cases.