Voice Failure

How is the voice created?

Hoarseness can be better understood by looking at how the voice is created. The vocal cords are located at the top of the windpipe, inside the organ we call the larynx. We all breathe in and out naturally, subconsciously, without thinking. The human voice is produced by expelling the air from our lungs during exhalation, the air passes through the vocal cords and vibrates them.

What Does Normal Sound Mean?

The sound created by the vocal cords is shaped by structures such as the pharynx, tongue and lips and finalised by resonating through structures such as the nose and sinuses. In order for a sound to be perceived as normal, its defining characteristics such as pitch, height, quality and variability are expected to be normal.

There are many different definitions of normal sound. My favourite, simplest and most memorable one is the following: ‘A sound that does not attract attention is a normal sound! ‘ What does this mean? A person's voice is considered normal if it is appropriate to the environment, age, height, weight and appearance of the person, i.e. it is not unpleasant or rejected by those who hear and listen to it.

What is hoarseness?

Hoarseness or abnormal voice can be defined as a voice that is not at satisfactory levels in terms of pitch, loudness, quality and variability as mentioned above.

To give an example of the defining characteristics of sound I mentioned earlier; if the pitch or frequency of the sound is lower (bass) or higher (treble) than it should be, we think that this sound is thinner or thicker than it should be.

If the loudness or intensity of the sound is not appropriate, for example if the sound is used at too low a level for the environment, we may not understand the person speaking and sometimes we may not even hear them. If a person uses their voice at too high a level, it may be perceived by the listener as strange or even unacceptable, as if they were being shouted at.

Voice quality, as a general definition, can be further broken down into categories such as breathiness, harshness and harshness. A study we conducted on how listeners evaluate voices in various ways is available at this link.

Hoarseness is a voice that easily attracts attention, creates the impression of being different from normal, is problematic; it can negatively affect the social and professional activities of the individual; it is a voice that does not match the age, gender, social status and environment of the individual. 

What causes hoarseness? What are the causes of voice disorder?

Hoarseness can be caused by a benign or malignant disease in any of the organs and tissues necessary for voice production (such as the lungs, trachea, larynx, tongue, lips, brain and pharynx) or a functional disorder affecting voice formation. The frequency of causes of hoarseness varies according to the age of the individual. The distribution of causes of hoarseness in children is different than in adolescents or adults.

How to Diagnose the Problem Causing Voice Disorder?

Voice disorders are detected when the person himself or those around him realise that the voice is different from normal. By examining the person with an Ear, Nose and Throat Specialist, it can be understood what the primary condition causing hoarseness is. During the examination, technological tools and methods such as videolaryngostroboscopy, flexible fibreoptic endoscopy and acoustic sound analysis can be used in addition to routine ear, nose and throat examination tools.

Some cases of hoarseness are treated under the microscope with a method called phonemic microsurgery.

How to Treat Voice Problems?

There are many types of diseases that cause hoarseness. Some may cause short-term hoarseness, while others may cause long-term hoarseness. Hoarseness treatments can be roughly divided into four categories. The first is behavioural treatments, where individuals do and practice what is good for their voice and avoid what is bad for their voice. Behavioural methods can also be briefly defined as following the rules of vocal hygiene. You can click on this link for brief information about vocal hygiene.

The second treatment method includes medical or drug-based treatments. Medications can be administered orally, by injection or locally into the airway or vocal cords. The duration of treatment can vary from days to months depending on the disease.

The third treatment method is voice therapy. With voice therapy, which is the treatment of voice disorders, it is ensured that the voice is less adversely affected in different situations and becomes more resistant to disturbances.

Surgical Treatment of Hoarseness

The fourth method is surgical treatment of voice disorders. Depending on the cause of hoarseness, surgery can be planned as endoscopic (performed only through the mouth, without any external scar or incision) or open surgery. For 10 questions about voice surgery, you can click on this link. The choice of which method to use alone or which methods can be used together is made by the doctor and the patient according to the primary and secondary causes of the patient's hoarseness.