Voice Disorders

The generic term dysphonia encompasses the auditory-perceptual symptoms of voice disorders. Dysphonia is characterized by altered vocal quality, pitch, loudness, or vocal effort.

Signs and symptoms of dysphonia include

  • roughness (perception of aberrant vocal fold vibration);
  • breathiness (perception of audible air escape in the sound signal or bursts of breathiness);
  • strained quality (perception of increased effort; tense or harsh as if talking and lifting at the same time);
  • strangled quality (as if talking with breath held);
  • abnormal pitch (too high, too low, pitch breaks, decreased pitch range);
  • abnormal loudness/volume (too high, too low, decreased range, unsteady volume);
  • abnormal resonance (hypernasal, hyponasal, cul de sac resonance);
  • aphonia (loss of voice);
  • phonation breaks;
  • asthenia (weak voice);
  • gurgly/wet sounding voice;
  • hoarse voice (raspy, audible aperiodicity in sound);
  • pulsed voice (fry register, audible creaks or pulses in sound);
  • shrill voice (high, piercing sound, as if stifling a scream); and
  • tremulous voice (shaky voice; rhythmic pitch and loudness undulations).

Other signs and symptoms include

  • increased vocal effort associated with speaking;
  • decreased vocal endurance or onset of fatigue with prolonged voice use;
  • variable vocal quality throughout the day or during speaking;
  • running out of breath quickly;
  • frequent coughing or throat clearing (may worsen with increased voice use); and
  • excessive throat or laryngeal tension/pain/tenderness.

Signs and symptoms can occur in isolation or in combination. As treatment progresses, some may dissipate, and others may emerge as compensatory strategies are eliminated.

Auditory-perceptual quality of voice in individuals with voice disorders can vary depending on the type and severity of disorder, the size and site of lesion (if present), and the individual's compensatory responses. The severity of the voice disorder cannot always be determined by auditory-perceptual voice quality alone.

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