Many factors can cause voice disorders:

  • Vocal abuse (voice strain or overuse)
  • Illness such as colds or upper respiratory infections
  • Throat dehydration
  • Improper throat clearing over a long time
  • Allergies
  • Esophageal reflux
  • Aging
  • Scarring from neck surgery or from trauma to the front of the neck
  • Drinking
  • Smoking
  • Cancer
  • Thyroid problems
  • Neurological disorders
  • Psychological stress
  • Normal menstrual cycle

  • Diagnosing voice disorders starts with a detailed history and a thorough physical examination. Mayo Clinic doctors have many diagnostic tools available to help determine the cause of a voice disorder, including:

    • Mirror exam -- By placing a mirror at the back of the throat, doctors can inspect the vocal folds for abnormalities.
    • Flexible laryngoscopy -- A flexible viewing tube is inserted into the nose to allow doctors to view the vocal folds. The tube has a light at one end and a viewing piece or camera at the other.
    • Video stroboscope -- A video camera combined with a flashing light source offers a slow-motion view of vocal fold movement.
    • Acoustic (sound) analysis -- This test measures irregularities in the sound produced by vocal fold movements.
    • Direct laryngoscope -- Doctors use a rigid viewing scope to examine vocal folds

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Once the diagnosis is determined, Mayo Clinic doctors recommend one or more treatments:

Hygiene, Hydration and Voice Therapy

Often, the most effective treatment for vocal disorders is practicing proper hygiene and hydration. Like any other part of the body, the vocal folds need regular rest and fluids. Mayo Clinic specialists provide guidance about how to use and rest the voice, how to properly clear the throat and the correct amount of fluids to drink. Mayo Clinic's Speech Pathology Department evaluates and treats language disorders of adults and children.

If an irritant is causing the voice disorder, doctors can identify and remove the cause. For example, if an allergy is causing excess mucus in the throat, specialists in allergic diseases can identify the allergen and provide treatment. If smoking is the cause, the Mayo Nicotine Dependence Center offers programs to help people address tobacco dependence.

Medications

Several medications are available for treating voice disorders. These medications can be taken orally, injected into the vocal folds, or applied topically during surgery -- depending on the underlying cause of the voice disorder.

Surgery Options

Removal of lesions -- Lesions (polyps) usually only form on the vocal folds after months or years of abuse. They can occur from a combination of events such as a respiratory infection and chronic voice misuse. When a permanent lesion forms, it takes up space between the edges of the vocal folds and disturbs airflow to the lungs. To regain normal airflow, the lesion must be surgically removed. To make performing vocal disorder surgeries easier, Mayo Clinic doctors use a type of anesthesia delivery system called jet ventilation. With jet ventilation, the anesthesia is delivered through a small stainless steel needle, freeing up workspace for the surgeon.

Bulk injection -- If vocal folds are determined to be too far apart, Mayo Clinic physicians may inject or implant a substance such as body fat or collagen (a synthetic material) to add bulk to vocal folds. This moves the folds closer together so they can more easily make contact.

Thyroplasty -- This surgical procedure adjusts the cartilage by pushing the folds together, relaxing or stretching them. This is often used for vocal fold paralysis. Thyroplasty has the added benefit of not disturbing the movement of vocal fold lining tissue, which helps preserve the voice.

Botulinum (Botox) toxin treatments -- The purpose of this treatment is to decrease muscle spasms or abnormal movements for people who have spasmodic dysphonia (a neurological movement disorder that affects the vocal muscles of the larynx). During the treatment, doctors inject tiny amounts of purified toxin into muscles, causing them to relax for up to five months.