Categories of Voice Disorders
Structural disorders are caused by some lesion (physical abnormality) of the larynx.
- Contact Ulcers
- Nodules (nodes)
- Miscellaneous growths
Neurological Voice Disorders are caused by some problem in the nervous system as it interacts with the larynx. See our About the Voice page for more information. Briefly, two nerves come from the brain to the larynx and control the movement of the larynx. The most important of the two nerves, the recurrent laryngeal nerve, comes down from the brain and wraps around the aorta before going back up to attach to the larynx on the left side. Because of this position in the neck, the recurrent laryngeal nerve is vulnerable to damage during cardiac, pulmonary, spinal and thyroid surgeries. When the nerve is damaged, it causes a paresis (weakness) or paralysis (complete lack of movement) in the vocal fold of the affected side. Other neurological voice disorders are related to other kinds of problems in the central nervous system.
- Spasmodic Dysphonia (Laryngeal Dystonia)
- Tremor (Benign Essential Tremor)
- Voice problem caused by another neurological disorder (e.g. Parkinson's disease, myasthenia gravis, ALS/Lou Gherig's Disease)
Functional disorders are caused by poor muscle functioning. All functional disorders fall under the category of muscle tension dysphonia. The different disorders listed here refer to different patterns of muscle tension. Remember that there can be a disorder in which there is no change to the sound of the voice, but rather that voice use causes additional effort, discomfort, or fatigue.
- Muscle tension dysphonia (general)
- Anterior-posterior constriction
- Pharyngeal constriction
- Ventricular phonation
- Vocal fold bowing
Psychogenic disorders exist because it is possible for the voice to be disturbed for psychological reasons. In this case, there is no structural reason for the voice disorder, and there may or may not be some pattern of muscle tension. While it is quite common for a psychological or emotional component to exist in a voice disorder, voice disorders that are caused by a psychological disorder are relatively rare. The two most common types of psychogenic disorders are listed on the right.
- Conversion dysphonia or aphonia
- Puberphonia (mutational falsetto)