Muscle Tension Dysphonia
Muscle Tension Dysphonia (MTD) occurs with there is tension in the muscles around the larynx. It is often described as “squeezing the voice out” and the voice sounds strained, tight, hoarse, rough and sometimes raspy or gravely. Voice treatment focuses on redirection and relaxation of the laryngeal muscles, improved breath support for powering the voice and exercises to improve coordination between respiration and phonation demands.
Vocal Cord Nodules and Polyps
They are noncancerous growths that appear on the true vocal cords as a result of vocal abuse or misuse of the voice during speaking and or singing. Nodules usually appear on both vocal cords while polyps can appear on one cord or both. Polyps may form as a result of untreated reflux, and /or vocal abuse.
Vocal Cord Paralysis
Vocal cord paralysis can occur on one or both of the vocal cords. Paralysis of the vocal cords may present in several different positions: one of both cords can be paralyzed in the open or closed position. The most common form of vocal cord paralysis involves one cord (unilateral) in the closed (at mild line) or in the open position. Different vocal patterns result depending upon the cords involved and the position of the paralyzed cord or cords.
Laryngeal Cancer
Throat cancer can be life threatening and significant effect quality of life if not treated early. Chronic hoarseness or change in vocal quality that lasts for more than 2 weeks warrants a complete ENT and voice evaluation complete with visualization of the larynx.
Laryngeal Candidiasis
Candida is a yeast that is present in the oral cavity, ears, and other body surfaces. Candida overgrowth can lead to infections of the larynx when the immune system and the protective mucosal barrier are impaired. Candidiasis and other fungal infections are commonly seen in immunocompromised patients and with those using asthma inhalers. Candidiasis can also be observed in healthy individuals. Antifungal medications are used to treat.
Poor Vocal Hygiene/Decreased Hydration
Daily water intake is vital to the proper function of the true vocal cords. Proper hydration allows the cords to freely move and vibrate in the most efficient manner. Poor hydration results in thick, copious secretions that tether the vocal cords and contribute to further abusive behaviors such as throat clearing and coughing.
Papillomas
Laryngeal papillomas are benign lesions that are viral and exhibit a wart-like appearance. They can occur on the vocal cords, above or below the vocal cords. Papillomas are highly recurrent, can be very aggressive and resistant to treat and may compromise the airway.
Leukoplakia
Leukoplakia exhibits a white patch appearance on the covering of the true vocal cords. Irritants such as smoking, environmental pollutants and gastroesophageal reflux may cause leukoplakia.
Paradoxical Vocal Fold Movement (PVFM)
PVFM is a voice disorder that results when the vocal cords remain in a closed tight position when they should open for the patient to breath. These episodes can be a frightening experience for patients and can be mistaken for asthma and often results from untreated reflux.
Gastroesophageal Reflux Disease: GERD
Gastroesophageal Reflux Disease (GERD) symptoms occur when a small valve between the stomach and esophagus opens at inappropriate times. When this happens, digestive and stomach acid can “back up” or reflux from the stomach into the esophagus leading to symptoms such as frequent heartburn, bitter/acid taste in mouth, swallowing or voice problems. . Strobe exam may exhibit post cricoid edema, interarytenoid pachydermia, TVC edema, red and irritated arytenoids, granulomas of the vocal cords and significant laryngeal pathology of any type.
Laryngopharyngeal Reflux Disease: LPRD
Laryngopharyngeal Reflux Disease (LPR) is often referred to as “silent reflux” because patients do not suffer from the typical symptoms of heartburn. LPR presents symptoms such as frequent throat clearing and coughs, feeling of a “lump” in the throat, throat pain, hoarseness, or swallowing problems. Strobe exam may exhibit post cricoid edema, interarytenoid pachydermia, TVC edema, red and irritated arytenoids, and granulomas of the vocal cords.
Granulomas
Laryngeal granulomas are benign masses that develop as a result of chronic irritation and inflammation. The irritation can be from chronic reflux, post intubation, or direct trauma to the larynx. Granulomas can also develop from repeated and forceful muscle contractions of the larynx during talking, singing, yelling and or coughing and throat clearing.