Voice Disorders
Adult Service Areas
If your voice quality does not align with your age, gender, or culture, you may have a voice disorder. Hoarse voice quality, voice breaks, vocal fatigue, difficulties with volume, and pain when speaking are some of the signs and symptoms of voice disorders.
Most voice issues are treatable – the vocal cords are a muscle and can be trained and strengthened like every other muscle in the body. Voice disorders can typically be described as:
Functional: difficulties caused by the way the vocal cords move. For example,
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- Muscle tension dysphonia
- Functional aphonia (voice loss)
- Puberphonia
- Vocal fatigue
- Resonance or pitch
Structural: difficulties caused by changes to the structure or nervous system control of the vocal cords. For example,
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- Laryngitis or swelling of vocal cords (as may be caused by vocal abuse or acid reflux)
- Vocal nodules
- Polyps
- Bowing of the vocal cords, secondary tParkinson’s disease or age related changes
- Vocal tremor
- Spasmodic dysphonia
- Paralysed vocal cords
- Voice issues following intubation or thyroidectomy
While voice issues can be categorized as functional or structural, structure can impact function and vice-versa. For instance, as a body tries to compensate for vocal nodules, you may struggle with vocal fatigue and vocal strain. Similarly, pushing through vocal fatigue and strain can lead to the development of vocal nodules.
If you are struggling with a functional voice disorder, an SLP can help you change the movement patterns of your vocal cords. The movement of your vocal cords is driven by your breath and the quality of the sound is further shaped by your vocal tract and resonant spaces. An SLP can help you find a more clear, effortless voice by training your breathing, resonance, and laryngeal systems (vocal cords) to work together.
If you are struggling with a structural voice disorder, an SLP can help you optimize vocal function and teach you compensatory strategies as needed. Some structural changes may require surgery – for instance, polyps are not expected to improve with voice therapy alone. In these situations, an SLP can help you manage your voice while awaiting other treatment, and help you return to normal voice activities afterwards. Other structural changes, such as vocal nodules, can be expected to heal with appropriate voice therapy and time.
In the case of gender affirming voice care, the structure of the vocal cords and size of the voice box may mean that certain vocal ranges are easier to produce. However, upper and lower vocal ranges can be trained, and managing resonance and prosodic features can further alter how feminine or masculine a voice is perceived to be.
If it is possible that your voice issue may be due to a structural disorder, we will recommend an Ear Nose and Throat doctor (ENT) assessment before starting therapy. Visual assessment of the vocal cords by an ENT can provide us with important information.
At Speech Pathways, we have SLPs who can support you in meeting your voice goals. Whether you are working to feel more confident with your sound, or resolve a structural/functional voice issue, we welcome the opportunity to help you find your voice.