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By Erika Stewart, B.S. Speech Pathology and Audiology, M.S. Management

Vocal cord disorders and treatments affecting musicians

According to the American Speech-Language and Hearing Association, there are four common voice disorders, all of which are symptomatically similar and may require both clinical and neurological evaluation to diagnose.

  • Nodules, Polyps and Cysts
  • PVFM (Paradoxical Vocal Fold Movement)
  • Spasmodic Dysphonia (uncontrolled quivering of the vocal folds)
  • Vocal Cord Paralysis

Voice is the sound that is produced through forced air from the lungs creating vibrations of the vocal folds in a person's throat, mouth and larynx (or voice box). The aforementioned disorders affect one or more of the parts of the speech anatomy. Depending on the cause, severity and specific diagnosis, there have been varying degrees of success in treating voice disorders. While overuse of the vocal cords by musicians may or may not be the primary cause of the condition, properly caring for ones vocal cords and remaining voice-producing anatomy plays a role in the success or failure of treatment.

Symptoms of a voice disorder may include:

  • Hoarseness or breathiness
  • A rough or scratchy sounding voice
  • Jerky or quivery voice
  • Aphonia (no sound)
  • Pain in the ears, neck or throat
  • Feeling a lump in the throat
  • Changes in pitch or range
  • Voice or general fatigue

Causes of voice disorders may include one or more of the following:

  • Irritants and environmental factors, such as smoke, or chemicals, such as ammonia or pollen
  • Overuse of the vocal cords by singing, shouting or loud talking
  • Acid reflux
  • Coughing
  • Breathing cold air
  • Psychosocial and neurological contributors
  • Injury or illness, such as trauma, tumors or stroke
  • Drying out the vocal cords by drinking caffeine or alcohol

Treatment options generally include medical, surgical or behavioral interventions and frequently a combination of all three. Behavioral or therapeutic interventions are the least invasive and involve the services of a speech-language pathologist to address breath control, abusive vocal behaviors, voice control of pitch, speech loudness and breathe support. Speech pathologists are trained clinicians who specialize in observing vocal behaviors and teaching exercises to control or reduce stress, optimize vocal performance, improve vocal health and relax the vocal cords and surrounding muscles. When psychosocial or psychological factors such as extreme stress reactions contribute to the disorder, a referral for mental health counseling may be in order.

Medical interventions include radiation and chemotherapy for treatment of tumors, as well as medication to alleviate allergic reactions, acid reflux, stress and thyroid disease or Botox injections to treat the quivering vocal cord symptoms from spasmodic dysphonia. While some success in treating the symptoms of spasmodic dysphonia has been realized, this is the hardest of the disorders to diagnose and currently there is no known cure.

Surgical interventions are required for removal of large nodes, polyps, cysts and tumors, and for reconstruction when disorders are caused by injury or misaligned vocal cords. Advancements in surgical procedures in recent years has led to significant improvement in voice control and rehabilitation following medical and surgical procedures.

As with any illness, the best medicine is prevention. Rest, avoid environmental irritants and hydrate vocal cords to reduce the risk of developing vocal cord disorders.

Article sources
(American Speech Language and Hearing Association)
(National Institute of Deafness and other Communication Disorders)

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