Violation of phonation

1. Functional dysphonia

  • 1) hypertonic dysphonia - due to overexertion of the voice, frequent laryngitis (hard and hoarse voice); complications - incl. nodules of vocal cords (the so-called "nodules of singers");

  • 2) hypotonic dysphonia - due to the weakening or overexertion of the voice (matt, hoarse voice);

  • 3) psychogenic aphonia - absence of a voice at preservation of sonorous cough and laughter, accompanying psychosomatic frustration;

  • 4) dysfunction of the vocal folds - the paradoxical closure of the vocal folds on the inspiration, which provokes attacks of inspiratory dyspnea, a feeling of compression in the throat, a change in the voice, whistles (often mistakenly diagnosed bronchial asthma, which is characterized mainly by expiratory dyspnea), stridor. The diagnosis is based on anamnesis, Stroboscopy, rhino and laryngoscopy and spirometry (including smoothing of the inspiratory curve).

  • Treatment: specialized phoniatrics, reduction of the voice load, breathing exercises, sometimes psychotherapy.

    2. Organic dysphonia

    Causes: anatomical disorders and malformations, nodules of vocal folds, polyps of vocal cords, tumors, cysts, granulomas (post-indubation or with gastroesophageal reflux disease), contact ulcers, trauma, damage to vocal folds of the central (eg, defeat of the motor nucleus of the vagus nerve[сосуществуют дисфагия и першения], disease Parkinson's disease) and peripheral (most often with lesions of the recurrent laryngeal nerve when surgery on the thyroid gland, with mediastinal or bronchial tumors, aortic aneurysm or typhoid changes).

    Symptoms of: aphonia or hoarseness, a change in voice quality, you need to make efforts for phonation.

    Diagnostics: on the basis of laryngoscopy and stroboscopy (excitation of vibration and closure of vocal folds).

    Conservative treatment rarely gives a positive effect; Microsurgical interventions and speech therapy rehabilitation are recommended.