Voice Disorders
Voice problems can occur as the result of structural problems or conditions which affect the larynx (voice box), inappropriate or abusive use of the voice, or from emotional stress. There are many types of voice problems. A disordered voice may be one which sounds too high or too low in pitch, too loud or too soft, or a voice which is hoarse or breathy. In some cases a person may experience weakness or loss of voice, fatigue after talking for a long period of time, or pain in the region of the larynx. Voice disorders occur in all age groups and, although some professions (singers, teachers, coaches, etc.) and some activities (yelling, smoking, excessive coughing, etc.) are more often associated with certain types of voice problems, voice disorders can affect people from all walks of life. A voice disorder may be limited to simply a problem with the voice or it may be a sign of other more serious problems. The category of voice disorders also applies to those who have had their larynx surgically removed in a procedure known as a laryngectomy.
A voice assessment consists of sampling the voice in a variety of speaking situations such as conversation, oral reading, whispering, and sometimes singing. In addition to sampling typical voice usage, it is also helpful to determine the capabilities of the voice. That is, an attempt may be made to determine the persons' pitch range, how loud and how soft the person can speak and how long a voiced sound can be prolonged. In addition to listening to the voice, several instruments can be used to make scientific measures of the acoustic qualities of the voice.
Many different conditions can result in similar voice symptoms. Also, in some cases, voice problems may be an early symptom of more serious medical problems such as neurological disorders, endocrine disorders or laryngeal cancer. For these reasons, most voice clients are referred to a physician specializing in disorders of the ear, nose and throat before any program of voice therapy is undertaken. This physician, known as an otolaryngologist, will examine the patient in order to determine if there is a problem in the structure or function of the larynx. It is the physician who will find such laryngeal growths as vocal nodules, polyps, cysts or ulcers. The physician will also determine if the vocal cords are weak or paralyzed or if any medical condition exists which may require treatment in addition to or instead of voice therapy.