Dysphonia

Dysphonia ( Dysphonemie, voice disorder ) is an impairment of the vocal part of the articulation (also called phonation ) in diseases or disorders of the larynx and the vocal tract.

The voice sounds depending on the findings and severity hoarse, rough, busy or aspirated. The voice is often no more "flexible". The tone, pitch and volume can be varied only in the reduced extent by the person concerned then often. The speaker then feels uncomfortable, felt a feeling of dryness or Fremdkörper-/Kloßgefühl in the throat and clears his throat often compulsive. This increased pressure enhances the vocal vocal impairment. The maximum form is a voicelessness ( aphonia ).

For permanent overuse is a danger - secondary organic changes, such as vocal cord nodules.

Causes

Voice disorders can have organic and functional causes. Organic causes are, for example, inflammation, paralysis, benign and malignant neoplasms (eg, polyps, nodules, granulomas, laryngeal cancer), but also a reflux of stomach acid ( gastric laryngitis ). In rare cases, are laryngeal injuries or congenital malformations of the larynx.

The functional dysphonia may originate in an overload ( ponogene D. ), in voting injurious speech habits ( habitual D. ), a system-dependent weak vocal apparatus ( Constitutional D. ), a type conversion neurosis ( psychogenic D. ), as well as a symptom of general physical illness (symptomatic D. ) have. Depending on the clinical manifestation of hyper- and hypo- functional dysphonia are ( "too much " or "too little" use of force ) differed.

Voice changes also occur with hormonal changes during the menstrual cycle, but also during puberty or menopause, and are to some extent normal. Also medications can cause side effect by different way voice disorders, eg, by dehydration of the mucous membranes in neuroleptics ( systemic effect by reducing the Speichel-/Schleimproduktion ) or asthma sprays (local dehydration due to the spray).

"Special " forms

The following " special " forms of dysphonia are described in older literature:

• Dysphonia clericorum painful to speakers (for example, preachers ), as a result of overuse of the voice, mostly.
• Dysphonia paralytic in damage to the vagus nerve or its branch laryngeal nerve (usually inf. ) [ N. recurrens ].
• Dysphonia puberum during voice broke.
• Dysphonia spastica ( spastic aphonia or Mogiphonie ); pressed, chopped, creaking voice onset by compression of the vocal folds and the ventricular folds during phonation trial, especially in speakers or as a neurotic symptom. ( to be distinguished from spasmodic dysphonia of, a form of dystonia )
• Dysphonia senilis; Age of voice

Diagnostics

The comprehensive medical diagnosis always includes laryngoscopy ( endoscopy ) of the larynx stroboscopy or high-speed camera and one auditory tuning results for the speaking and singing voice. This is complemented by the apparatus detection of electrophysiological parameters such as fundamental frequency, jitter, shimmer, etc., by the Electroglottography and create a voice box.

Therapy

Functional voice disorders are usually treated in a specific voice therapy at phoniatrists, respiratory, speech and voice teachers and speech therapists ( for example, breathing rhythmically adapted phonation ) by setting it to the physiological phonation. For organic voice disorders come depending on the findings most surgical procedures used, in which the changes under general anesthesia or local anesthesia (see phonosurgery ) are removed. Malignant changes usually require a generous removal of the tumor with then often remaining, permanent voice disorder.