What is dysphonia?

Dysphonia, often known as hoarseness, is a voice impairment causing the voice to involuntarily sound raspy or strained, softer in volume or lower in pitch. It is often associated with problems in the vocal cords found in the larynx (voice box). In both children and adults, chronic aphonia (inability to produce voiced sound) may develop, which requires medical attention in order to diagnose what is causing this.

When dysphonia develops, rest is normally advised, but if the condition lasts more than two weeks, a doctor should be seen to rule out the presence of any serious injury and to prevent dysphonia from developing into chronic aphonia, resulting in a total loss of voice. When dysphonia has developed, either from forcing the voice too much or infections and viruses, rest, anti-inflammatories or, depending on the case, speech therapy will be required.

There are two types of dysphonia:

• Acute dysphonia: Usually self-limited, and resolves with rest and symptomatic treatment.
• Chronic dysphonia: More complex, since it can have multiple causes, from tumour lesions to congenital anomalies.

Disease prognosis

In most cases, dysphonia can be effectively treated by following the appropriate treatment, since it is most often caused by an infection that causes inflammation. If the problem lasts beyond two weeks, the patient should be referred to an ENT specialist to perform a thorough examination of the vocal cords and voice box.

Symptoms of dysphonia

The most common symptoms are:

• Hoarseness
• Monotonous voice
• Tremor in the voice
• Aphonia
• Variations in voice intensity and loss of treble (the highest pitch)

In addition, other symptoms may occur, which don’t affect the voice, such as a cough, itchy throat and mild or moderate throat pain.

Diagnosis of dysphonia

There are no specific tests for dysphonia, and it’s usually diagnosed based on the patient’s description of the symptoms and the sound of the patient’s voice.

An otolaryngologist might observe the vocal folds during speech using a flexible fibre optic laryngoscope which is inserted through the nose.

What are the causes of dysphonia?

When dysphonia occurs in children, it can be caused by neurological disorders, malformations of the larynx, viral infections, or by forcing the voice too much. The latter is the most common cause of dysphonia in adults.

Other factors can trigger dysphonia, such as gastroesophageal reflux, smoking, infectious processes such as laryngitis or tuberculosis, neurological disorders of the larynx or tumours.

Can it be prevented?

Dysphonia can often be prevented.

People are recommended to:

• Not excessively clear their throat
• Avoid agents that dehydrate the body
• Avoid dry environments
• Avoid smoking
• Rest properly
• Humidify your home
• Avoid excessive spicy food and alcohol
• Try not to force their voice or use it for too long or too loudly

Treatments for dysphonia

Dysphonia can be treated by resting the voice and modifying lifestyle habits, such as smoking and drinking more fluids. In the event that the dysphonia is caused by an infection, anti-inflammatory medication should be used.

What specialist treats it?

A specialist that treats dysphonia is an otolaryngologist.