When voice changes persist: Understanding Dysphonia

A blog-style, short article for the public explaining Dysphonia causes, symptoms, diagnosis, treatment and when to seek medical advice.

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As the colder months set in and the heaters come out, many brace for runny noses, coughs and sore throats; the latter often accompanied with temporary changes to your voice. However, when these changes occur and persist without the symptoms of a cold, it may indicate something more. More complex and nuanced than a temporary hoarse voice, Dysphonia, more commonly known as a voice disorder, affects approximately 1.5 million people in the UK. For a condition that affects many, it is poorly understood; with those affected often assumed to have lost their voice from the seasonal flu. In this blog, I will explain what Dysphonia is, how the voice works, and when it may be time to visit your GP.

Dysphonia: What it is and Symptoms
Dysphonia is an umbrella term for disorders of the Larynx (voice box) and causes changes to the sound, pitch, volume, and tone. Those affected experience (and not limited to), a voice that requires more effort to produce than normal, sounds weak, is rough, tires easily and shortness of breath when speaking.

Back to basics: Understanding how the voice works
Your voice works by two key mechanisms: movement and synchronisation. Two strips of muscle, called the vocal cords, simultaneously move towards each other to produce your voice. Think of clapping – without your right or left hand working together, you cannot produce a clap. Similarly, without either vocal cord moving to meet the other, there will be no voice production. When you are not speaking, your cords relax, leaving a small gap where air passes through allowing you to breathe.

What causes Dysphonia:
There is not a single cause of Dysphonia; however, we can assume anything that affects the appearance and structure of the cords will affect the voice quality.

These include (not limited to):

·       Growths on one of both cords such as nodules, polyps, and cysts – this does not allow the cords to fully close and causes voice change.

·       Paralysis of one or both cords – this may cause difficulties breathing and speaking.

Important to note, there are some cases where no visible differences to or on the cords are present, yet vocal changes occur. These are known as Idiopathic voice disorders, meaning they have no known cause. Some voice disorders like Spasmodic Dysphonia, have no causal origin in the vocal cords, but is the result of a disruption in communication within the brain.

How is it diagnosed?
Whilst listening by ear is one easy marker for any vocal issue and is the first step towards diagnosis, diagnosis requires accuracy. GPs usually ask for a description of your symptoms and alongside these may perform a flexible laryngoscopy. This gives a live visual of your throat by passing a thin, flexible tube with a small camera at the end, through your nose to your throat.

What treatment options are there?
Some experience their voice returning to normal on its own, and whilst this is the hope for all, usually, these voice changes are long-lasting, and intervention is needed for any potential of recovery. Treatment focuses on a mixture of symptom management and targeted therapies. Many patients undergo sessions of speech and language therapy to improve breath control, breathing and speaking coordination, alongside voice education and care.

Injections, administered directly into the cords, are common treatments. Depending on the dysphonia and individual treatment plans, injection types and proceedings may differ, but all aim to increase voice strength and restore smooth communication. Think of the botox used in cosmetics in your face but, in your throat.

In some cases, surgery may be the only option to improve patient voice. This is common with vocal cysts.

When to seek Medical Advice:
It is usually no major concern when you lose your voice, especially the occasional occurrence in individuals who use their voices professionally. However, it is worth checking with your local GP if symptoms persist for two weeks. Better that than pushing through. Symptoms go beyond what has been mentioned in this blog. Persistent voice changes should always be assessed to rule out underlying conditions.

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Interested in patient-friendly health content? Get in touch at: sarahwriteshealth@gmail.com

Sarah Adeniyi
Aspiring Health & Medical Writer | Voice Disorder Advocate
📧 sarahwriteshealth@gmail.com
🔗 LinkedIn: www.linkedin.com/in/sarah-a-283892215


Sources:
The Lary Project. (n.d.). Surprising facts. https://lary.org.uk/about/surprising-facts