Common voice problems

Written by: Professor Martin Anthony Birchall
Published: | Updated: 07/08/2019
Edited by: Top Doctors®

The most common cause of voice problems are short-term respiratory tract infections which are managed by general practitioners. If it goes on for longer than three weeks, patients should be referred to see a specialist.


Causes of voice problems

The most common cause of longer-term problems with the voice are, firstly, tension, a tightness of the larynx and the muscles around it. This can result from stress, it can be a leftover of an upper respiratory tract infection, or it may the result of using the wrong muscles to talk with as we get older. All of these things can be diagnosed in the clinic. Another common cause of voice problems is reflux, an epidemic in the western world. People are getting more and more overweight and their diets aren’t ideal. Acid coming up from the can stomach not only affect the gullet or the esophagus but it can also affect the larynx as well causing inflammation and voice problems.


We use small telescopes to look at patients’ throats. These may either be passed through the mouth or, more commonly, through the nose which gives us clear views of their throat and allows us to diagnose voice problems at an early stage and give people accurate treatments and diagnoses.


When one cord is not moving properly in the voice box, it results in hoarseness. People find it difficult to generate any power. In fact, they have to produce about eight times the normal amount of power to get the kind of voice that most people would generate normally. This is very tiring and they run out of breath. Also because the vocal cords don’t come together properly, food and drink might go down the wrong way, leading to problems eating and drinking. Problems with fluids can lead to repeated chest infections.

Vocal cord paralysis

Now, most people with vocal cord paralysis get better over a period of six months to a year. During that time, they can be managed easily by a combination of speech and language therapy and vocal cord injections. Where the paralysis is more permanent, we use a different approach, we push the cords closer together on a permanent basis The method of doing this is to create a small block of medical grade plastic called silastic and to carve it into a wedge shape that fits into the side of the voice box and pushes the cords closer together.

Read more: how does ageing affect the voice?

By Professor Martin Anthony Birchall
Otolaryngology / ENT

Professor Martin Birchall is a world-leading academic, renowned surgeon, and pioneer in the field of laryngology. He is a specialist in voice, swallowing and breathing problems as well as coughs and neck lumps. He co-led the first team that used stem cell-based organ transplants and continues to dedicate himself to pioneering life-altering techniques via his active research and presence in the field.

He is currently the principal investigator on four clinical trials, including one which is exploring a new way to restore voice functions using the drive from unaffected nerves. He treats vocal cord weakness (palsy) using the latest technology such as laryngeal reinnervation and transcutaneous vocal cord injections and is an expert in managing pharyngeal pouches (Zenker's diverticula) using techniques including lasers and transnasal oesophagoscopy. He is a supporter and medical advisor to a number of charities including the National Association of Laryngectomee Clubs, Shout Against Cancer and Youth Against Crime. 

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