What is Voice and How is it Produced?
Voice is produced when air from the lungs causes the vocal folds in the larynx (voice box) to vibrate. This vibration is shaped through resonance cavities such as the mouth, nose, and pharynx to become audible speech or sound.
Voice has three primary characteristics:
- Pitch: How high or low a voice sounds.
- Loudness: The intensity or volume of the voice.
- Quality: The tone of the voice (e.g., breathy, hoarse, or harsh features).
If one or more of these parameters are inappropriate for an individual, a voice disorder may occur.
What is a Voice Disorder?
A voice disorder occurs when the quality, pitch, or loudness of the voice is inappropriate for an individual's age, gender, or cultural background, or when it negatively affects their communication, profession, and social life. It is particularly common among professional voice users such as teachers, singers, and call center employees.
Classification of Voice Disorders
1. Organic Voice Disorders
These are disorders based on structural or neurological causes:
- Structural: Nodules, polyps, cysts, Reinke's edema, sulcus vocalis, laryngitis, or age-related muscle loss (presbyphonia).
- Neurogenic: Vocal fold paralysis, spasmodic dysphonia, vocal tremor, or voice changes related to Parkinson's disease.
2. Functional Voice Disorders
These conditions occur due to improper or inefficient use of the voice without structural damage to the larynx:
- Muscle Tension Dysphonia (MTD)
- Vocal fatigue
- Puberphonia (Mutational Falsetto - failure of the voice to deepen after puberty)
- Ventricular phonation (use of false vocal folds)
Pediatric Voice Disorders
The most common cause in children is vocal fold nodules. Attention should be paid to the following symptoms:
- Persistent hoarse, raspy, or breathy voice quality
- Becoming easily fatigued while speaking or singing
- Noticeable hoarseness especially in the mornings
Evaluation and Voice Therapy
The evaluation process is multidisciplinary; first, an ENT specialist performs a laryngoscopic examination, followed by an assessment of acoustic and perceptual parameters by a Speech and Language Therapist (SLT).
Voice Therapy Approaches:
- Direct Methods: Semi-Occluded Vocal Tract Exercises (SOVTE), respiratory coordination, resonance therapy, and LSVT.
- Indirect Methods: Vocal hygiene education and environmental modifications.
Golden Rules for Vocal Hygiene
- Adequate daily water consumption (Vocal hydration)
- Avoiding shouting or whispering while speaking
- Staying away from smoking and alcohol
- Limiting foods and drinks that trigger acid reflux
- Ensuring adequate sleep and practicing vocal rest when the voice feels fatigued
If hoarseness or changes in your voice persist for more than 2 weeks, you should definitely consult a specialist.
You can schedule an appointment at the Istanbul Atlas University Speech and Language Therapy Unit.