Dysphonia

Dysphonia is any qualitative voice disorder that changes its pitch, volume, timbre, or clarity. This term describes a wide range of voice disorders, from mild huskiness to severe hoarseness, with the extreme form being aphonia — complete loss of voice.

Dysphonia is not an independent disease, but a symptom indicating pathology in the larynx or dysfunction of the vocal apparatus. It occurs because the vocal folds cannot close or vibrate properly.

Aetiology and pathophysiology

The causes of dysphonia are numerous and are divided into organic (related to structural changes) and functional (related to improper use of the vocal apparatus).

• Organic causes:
  • Inflammatory diseases. Laryngitis (acute or chronic) is the most common cause.
  • Benign masses. Nodules, polyps, or cysts of the vocal folds.
  • Paralysis of the vocal folds. Damage to the laryngeal nerve following thyroid surgery, injury, or viral infections.
  • Malignant tumors. Laryngeal cancer.
• Functional causes:
  • Voice strain. Typical for singers, teachers, lecturers.
  • Psychogenic factors. Stress, anxiety, depression.

Clinical Significance

Clinically, dysphonia manifests as a change in the usual sound of the voice: it may become weak, strained, tremulous, hoarse, or rough. This is often accompanied by rapid fatigue during conversation and a feeling of discomfort in the throat.

The “gold standard” for diagnosis is laryngoscopy (or videolaryngostroboscopy) — examination of the larynx and vocal folds using an endoscope. This allows structural changes to be visualised and the vibratory function of the folds to be assessed.

Any dysphonia that persists for more than two to three weeks, especially in smokers, requires mandatory examination by an otorhinolaryngologist to rule out oncology diseases. Treatment depends entirely on the cause and may include voice rest, medication, sessions with a speech therapist (voice therapy) or surgery.