Organic voice disorders are caused by a clearly visible organic mutation. This category includes:
- Deformities of the larynx
- Inflammations
- Cysts and polyps
- Tumours
- Paralyses
- Haemorrhages
- Traumas (injuries)
- Hormonal disorders
- Metabolic disorders
Drug therapy
In many voice disorders where an organic problem is diagnosed, drug therapy can bring about an improvement in the situation, for example in the case of:
- Reflux laryngitis
Reflux laryngitis is a chronic (chronic means long-lasting – not incurable) inflammation of the back of the larynx, which is closer to the oesophagus. Typical symptoms are the need to clear the throat, hoarseness, coughing and a feeling of soreness in the throat. - Chronic laryngitis with purulent sinusitis
Long-lasting purulent sinusitis can occur after a cold, among other things. The mucous membrane of the sinuses constantly produces some purulent secretion, which runs from behind the nose into the throat and also causes an inflammation there (syndrome descendens). The symptoms often mentioned are hoarseness and coughing or a reduced ability to strain the voice. In this situation, the cause of the disorder must be remedied, i.e. the sinusitis is treated with nasal spray, inhalation and, if necessary, antibiotics. Thus, the actual cause of the voice disorder is treated. Usually with a certain delay the situation in the throat improves.
Functional dysphonia / dysody (voice disorder of the speaking or singing voice): Functional dysphonia or dysody is a voice disorder without a clearly visible organic cause. The muscles of the larynx that are used to produce the voice are in a very complex balance that can be described as unstable. This is one of the reasons why the movements are susceptible to disturbances. Causes of dysfunction (dyphonia or dysody) can be:
- Singing too much, too long, too loudly
- Singing technique that is either not developed enough, one-sided or that contradicts the physiology of the larynx
- Incorrect speaking habits or speaking technique.
- Lack of breathing technique or incorrect breathing technique
- Psychological disorders such as excessive stress or mental illnesses
Functional disorders can also occur secondarily, as a result of an organic disorder:
- After severe or prolonged colds
- With smokers
- With reflux
- Hormonal fluctuations
- But also with all other organic changes of the vocal folds (see above).
Vocal fold nodules/singing nodules also fall into the category of functional disorders. We prefer to speak of phonation thickenings. These are opposite mucosal thickenings on the free edge of the vocal folds. These thickenings can be compared to calluses on pressure-loaded areas on the body, e.g. on hands or feet. They cause a reduced ability of the vocal folds to vibrate – the voice needs more air pressure to respond. These phonation thickenings or vocal fold nodules are usually caused by overuse or incorrect use and can be made to disappear with targeted therapy. Occasionally, surgical ablation is advisable.
Surgical therapy
There are various changes in the vocal folds that cannot be influenced either by improving vocal technique or by medication. Surgery may occasionally be the only way to improve the voice. In the case of singers, surgical interventions are only performed with extreme reluctance. Especially with singers, surgery is done as cautiously as possible. Salome Zwicky, MD, has extensive experience in ablation under local anaesthesia: vocal fold thickenings can merely be plucked away in the practice under local anaesthesia. Advantage: hardly any scarring, quick rehabilitation after the procedure.