- Structural: something is physically wrong with the mechanism, often involving tissue or fluids of the vocal folds.
- Neurological: something is wrong with the part of the nervous system that controls the voice.
The physical structure is normal, but the vocal mechanism is being used improperly or inefficiently.
The voice problem starts as a symbolic, or outward, manifestation of some unresolved psychological conflict.
A Special Note About Cancer
Laryngeal cancer is not considered a voice disorder. Cancer in the larynx or anywhere in the throat can cause a related voice problem, but our concern is not treating the voice disorder, it is treating the cancer. The voice may become disordered as a result of the cancer treatment, such as surgery or radiation treatment, in which case, the voice is treated as is any other voice disorder. We often do functional therapy in advance of surgery or radiation, in order to reduce the negative effects of these as much as possible. See our links page for web sites relating to laryngectomies and other information regarding throat cancer.
You probably know that unexplained hoarseness is one of the warning signs of cancer. If you have a change in your voice quality that lasts several weeks and can't be explained, it's a good idea to have your larynx examined by a doctor. This is especially true if you have a risk of cancer, related to smoking or exposure to other inhaled carcinogens.
If you have a diagnosis of hyperkeratosis or leukoplakia on your vocal folds, your doctor will be watching you carefully because those are considered pre-malignant lesions (they have the potential to turn into cancer). If you have any other kind of voice disorder, it WILL NOT turn to cancer.