What’s Wrong with Your Voice?

The following information on voice disorders is intended to supplement what a certified speech language pathologist or otolaryngologist has already told you. The descriptions of these voice disorders should not be used as the only source of your information, so we recommend that any individual with a voice problem be seen by an otolaryngologist for an examination.

What does Your Voice Sound Like?

Use this guide to help you search for what might be wrong with your voice. Remember:

  • We don’t know until we look. The suggestions below are just some of the most common possibilities. We can make guesses, but the only way to really know is to have a complete evaluation with an Otolaryngologist (ENT physician), and preferably with a team of specialists such as we have at the Lions Voice Clinic. Speech-Language Pathologists who are voice specialists are the most skilled at doing functional (behavioral) evaluations of the voice.
  • There are many excellent sources of information about the voice online, from qualified academic and medical sources. But there is also a lot of misinformation on the internet. Please search responsibly.
  • Even if you can’t find a good description of your voice problem on this website, it’s still a problem for you, and we’re here to help you solve it!

Categories of Voice Disorders

Your voice problem might be organic, functional or psychogenic. Please see the page on Categories of Voice Disorders for further information. The different types of disorders can often interact.

What is the problem with your voice?

For all of the descriptions below, the disorder could have an organic or a functional cause. Disorders with organic causes tend to have more constant symptoms, because the cause is always present. Functional disorders tend to be more variable, and sometimes the voice can be normal, depending on how it is being used.

My voice sounds hoarse, rough, raspy or gravelly.
Functional: any of the functional disorders can cause these symptoms.
Organic: any of the organic disorders, either structural or neurological, can cause these symptoms.

My voice sounds weak, breathy or tired.
Functional: Muscle Tension Dysphonia, Hyper Abduction, Vocal Fold Bowing
Neurological: Paralysis/Paresis; Other Neurological

My voice sounds or feels tired after talking or singing.
Organic: Any of the organic disorders can cause vocal “fatigue.” Usually, there will also be a difference in the quality of the voice with an organic disorder.
Functional: Any of the functional disorders can cause vocal “fatigue.” If the quality of the voice is generally normal, but feels tired with use, it is more likely functional.

I have discomfort in my neck or throat after talking or singing.
Organic: Any of the organic disorders can cause vocal discomfort. There will usually be a difference in the quality of the voice with an organic disorder.
Functional: Any of the functional disorders can cause vocal discomfort. If the quality of the voice is generally normal, but feels tired with use, it is more likely functional.

I feel that sometimes my words are choked, strangled or blocked.
Organic: Spasmodic Dysphonia (Laryngeal Dystonia)
Functional: Muscle tension dysphonia, ventricular phonation

I feel like my voice is "leaking," like there's silence or a burst of air and that words don't come out.
Organic: Spasmodic Dysphonia (Laryngeal Dystonia)
Functional: Muscle tension dysphonia, vocal fold bowing, hyperabuction
Psychogenic: conversion dysphonia or aphonia

I run out of breath sooner than I should when I talk or sing.
Organic: paralysis/paresis
Functional: Muscle tension dysphonia, vocal fold bowing, hyperabuction

I feel that my voice is worse in the mornings. My voice takes several hours to "wake up."
Organic: Paralysis/Paresis; Tremor; Reflux (see Related Problems)
Functional: Vocal Fold Bowing

I have a very dry, raw, burning, or stinging feeling in my throat.
Organic: Reflux (see Related Problems)
Functional: Ventricular Phonation; Muscle Tension Dysphonia; Anterior-Posterior Constriction; Pharyngeal Constriction

I get spasms in my throat so that I have difficulty breathing.
Vocal Cord Dysfunction/Functional Breathing Disorder (see Related Problems)

Irritable Larynx Syndrome (see Related Problems)

I can't sing as high/low, loud/soft, or as long as I used to.
Organic: any of the organic disorders can cause this.
Functional: Muscle Tension Dysphonia; any of the functional disorders can cause can this

My voice got worse with illness and did not return to normal when the illness resolved.
Functional: Muscle Tension Dysphonia
Organic:

  • Structural: Hemorrhage; Polyps: Cysts;
  • Neurological: Paralysis/Paresis

My voice became worse immediately following a surgery.
Organic:

  • Structural: Granuloma
  • Neurological: Paralysis/Paresis

Functional: Muscle Tension Dysphonia

My voice is just a whisper; nothing comes out.
Psychogenic: Conversion dysphonia/aphonia
Functional: Muscle Tension Dysphonia
Organic: Neurological: Paralysis/Paresis; other neurological (these are unlikely if there are no other symptoms)

My voice stayed high in pitch even after I went through puberty. I can’t find my adult male (low) voice.
Psychogenic: Puberphonia