Dysphonia and treatment

A voice disorder can be a sign of illness, a symptom, or an indicator of a communication disorder. The most important step is to determine whether the dysphonia is the reflection of an underlying disease and to identify its cause. Once the primary cause of dysphonia is diagnosed and treated, its impact on communication should be considered, and an appropriate therapeutic plan should be established. Additionally, dysphonia may or may not be accompanied by other local or systemic symptoms, such as dysphagia, vocal fatigue, fever, and more. Nevertheless, the term dysphonia refers to all audible voice alterations, not just to lesions of the vocal cords.

It is necessary to quantify voice quality. In dysphonic voices, quantifiable features may include increased perturbations in pitch and amplitude, known as jitter and shimmer; noise in the spectrogram and subharmonics; interruptions, pauses, or discontinuities in the voice during phonation; reduced phonation range and/or dynamic range; and even the appearance of amplitude and/or frequency modulation components.

The voice is also a key part of communication. Therefore, it is essential to assess whether the voice is intelligible for speech, aesthetically acceptable, and appropriate to social and occupational demands. Dysphonia affects up to 47% of the population and impacts all age groups. In children, prevalence ranges from 3.9% to 23.4%, with a peak between the ages of 8 and 14. Voice matters not only for health but also at the personal, social, and economic levels. In a study by Ingo Titze, it was noted that there are more than 30 professions in which the voice is essential for job performance, representing one-third of the workforce. Professions such as singers, actors, teachers, and telemarketers are obvious, but many others rely heavily on voice too: lawyers, sales clerks, retail workers, receptionists, fitness instructors, police officers, priests, and more.

The quality of life and the degree of impact caused by dysphonia are subjective. However, objective scales exist to measure social, occupational, and emotional dysfunction before and after treatment. The most commonly used is the Voice Handicap Index (VHI).

As Behlau states, “Voice is the main expression of our personality and the transmission of our emotions, and it changes with age, health status, personal history, and socio-economic conditions.”

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Valentina Carlile - Osteopath specializing in Osteopathy for Voice and Speech Disorders since 2002. For information and bookings, visit the Contact page.

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