Hoarseness / Dysphonia

Dysphonia is any impairment of the ability of the vocal cords to produce sounds and is generally benign. Learn about the causes and treatment options for Dysphonia or Hoarseness.

Dysphonia is defined as a voice that may still produce speech but sounds hoarse, weak, excessively breathy, harsh or rough.

Causes of Dysphonia

Dysphonia is an interruption in the ability of the vocal folds to vibrate normally during speech.

During normal phonation, the vocal folds come together to vibrate, creating sound. One can think of vocal cords as bowstrings that vibrate with varying lengths and tensions to produce certain pitches and sounds. Louder sounds are produced by increasing the airflow volume of the vocal cords themselves.

Weakness (paresis) or complete lack of movement (paralysis) of one vocal cord or side of the larynx can prevent cyclic vibration and lead to irregular movement in one or both sides of the voice box. This irregular motion results in a "breathy" voice.

Types of Dyphonia

Dysphonia has one of two types of causes: organic or functional

Organic Dysphonia

Organic dysphonia is due to a medical cause affecting the function of the larynx.

Causes of Organic Dysphonia:

• Laryngitis
• Vocal cord nodules, polyps, or cysts
• Reinke’s Edema (swelling often caused by smoking)
• Neoplasm (tumor)
• Trauma
• A few other rare disorders

Functional Dysphonia

Functional dysphonia is behavioral, occurring when voicing or compensatory behavior alters normal voice function.

Causes of Functional Dysphonia:

• Psychogenic
• Vocal abuse or misuse
• Idiopathic

Diagnosis of Dysphonia

Dysphonia is measured using a variety of examination tools (particularly laryngeal videostroboscopy) that allow the clinician to see the pattern of vibration of the vocal folds.

Flexible laryngoscopy is sometimes used as the first step to rule out malignancy or any mass effect on the vocal cords.