Vocal Cord and Voice Disorders

Vocal cord disorders are conditions that affect how your vocal cords function which, in turn, affects your voice. The vocal cords (also called vocal folds) are two bands of smooth muscle tissue found in the larynx (voice box). The larynx is located in the neck at the top of the trachea (windpipe).

The sound of your voice is produced when the vocal cords vibrate as air passes through them from the lungs. The voice sound is then amplified and modified by the throat, nasal passages, and mouth (what are called "resonators,") producing your recognizable voice.

Vocal cord/voice disorders are often caused by vocal abuse or misuse. This includes excessive use of the voice when singing, talking, coughing, or yelling. Smoking or inhaling irritants of any kind are also considered vocal abuse. Nervous system disorders also play a role in certain vocal cord/voice disorders.

If you or someone you know has a vocal cord/voice disorder, it’s important to know that most of these disorders can be reversed. And the Division of Otolaryngology – Head and Neck Surgery at Cooper University Health Care has a team of ear, nose, and throat (ENT) specialists, speech-language pathologists, and other professionals who are experts in helping you do so.

Why Choose Cooper to Treat Vocal Cord and Voice Disorders

As South Jersey’s only tertiary-care, academic health system, Cooper University Health Care is home to a team of highly trained professionals with extensive expertise in diagnosing and treating vocal cord disorders.

This includes fellowship-trained otolaryngologists (ear, nose, and throat specialists) who provide both medical and surgical care, and certified speech-language pathologists who specialize in preventing communication and swallowing disorders in children and adults.

What’s more, members of our team subspecialize in laryngology and care of the professional voice. As a result, we’re able to treat patients with complex conditions that other centers may not be equipped to deal with.

Types of Vocal Cord/Voice Disorders

Some of the more common vocal cord disorders include:

  • Laryngitis: Laryngitis causes a raspy or hoarse voice due to inflammation of the vocal cords. Laryngitis can be caused by excessive use of the voice, infections, inhaled irritants, or gastroesophageal reflux (GERD, or heartburn).
  • Vocal nodules: Vocal nodules are noncancerous growths on the vocal cords caused by vocal abuse. Vocal nodules are often a problem for professional singers. The nodules are small and callous-like. They most often grow in pairs (one on each cord). The nodules most often form on parts of the vocal cords that get the most pressure when the cords come together and vibrate. Vocal nodules cause the voice to be hoarse, low, and breathy.
  • Vocal polyps: A vocal polyp is a soft, noncancerous growth, similar to a blister. Voice polyps cause the voice to be hoarse, low, and breathy.
  • Vocal cord paralysis: Paralysis of the vocal cords may happen when one or both vocal cords doesn’t open or close properly. A common disorder, this condition can range from relatively mild to life-threatening. When one or both vocal cords are paralyzed, food or liquids can slip into the trachea and lungs. A person may have trouble swallowing and coughing. Vocal cord paralysis may be caused by:
  • Head, neck, or chest　injury
  • Problem during surgery
  • Stroke
  • Tumor
  • Lung or thyroid cancer
  • Certain neurological disorders, such as multiple sclerosis or Parkinson’s disease
  • Viral infection
  • Spasmodic dysphonia: With this voice disorder, involuntary spasms in the muscles of the larynx cause the vocal cords to stiffen and close, or remain open—or both. As a result, vibration can’t occur, so speech sounds are strained and full of effort (if vocal cords are closed), or weak, quiet, and whispery (if cords remain open). While the exact cause of spasmodic dysphonia isn’t known, a nervous system or movement disorder such as stroke, Parkinson’s disease, myasthenia gravis, ALS or multiple sclerosis is thought to cause most cases. It is a lifelong condition.

Risk Factors for Vocal Cord/Voice Disorders

These are some of the most common risk factors for each type of disorder:

  • Laryngitis: Having a respiratory infection like a cold or sinusitis , exposure to irritating substances (like smoke, stomach acid or excessive alcohol), or overusing your voice
  • Vocal nodules and polyps: Having a job that requires excessive voice use (such as singing, teaching, media), dehydration
  • Vocal cord paralysis: Undergoing throat or chest surgery, having a neurological conditions such as Parkinson’s disease or multiple sclerosis, stroke
  • Spasmodic dysphonia: Being female (it　most often affects women, particularly between the ages of 30 and 50), family history (the condition may be inherited), having a cold or the flu, injury to the voice box, a long period of voice use, stress

Symptoms of Vocal Cord Disorders

Symptoms vary, based on the type of vocal cord disorder, but generally include:

  • Changes in your normal voice such as a raspy or hoarse voice, or a hoarse, low, and breathy voice
  • Speech that is strained or difficult, weak, quiet, or whispery
  • Loss of vocal range
  • Vocal fatigue
  • Loss of voice
  • Vocal cord paralysis may also cause trouble swallowing and coughing

Any hoarseness or change in voice that lasts longer than two weeks should be brought to the attention of your healthcare provider. Sometimes the hoarseness may be from laryngeal cancer .

How Vocal Cord/Voice Disorders Are Diagnosed

In addition to a taking a complete medical history and performing a physical exam, your healthcare provider will likely examine the vocal cords using fiberoptic nasolaryngoscopy. This involves using a lighted tube, passed through the nose into the voice box, to check movement of the vocal folds during speech.

In the case of vocal cord paralysis, your healthcare provider may also perform laryngeal electromyography, a test　that measures the electrical current in the vocal cords.　　

How Vocal Cord Disorders Are Treated

Treatment depends on the specific vocal cord disorder, its cause and severity. It may include:

  • Resting the voice
  • Stopping the behavior that caused the vocal cord disorder
  • Voice therapy with a speech-language pathologist who specializes in treating voice, speech, language, and swallowing disorders
  • Medicine
  • Surgery to remove growths
  • Surgery to cut one of the nerves of the vocal folds
  • Injecting Botox directly into the affected muscles of the voice box to ease spasms
  • Counseling and support groups to help cope with the stress that difficulty speaking can cause
  • Technology that aids communication; advances include computer software or cell phone apps that translate text into speech

It’s important to know that with proper "voice hygiene," many vocal cord/voice disorders are easily preventable.

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