Resources: Speech Disorders
Voice Problems

What is voice?

Voice is the sound produced by the larynx (LAR-inks), commonly called the voice box.

Where is the larynx (voice box) located?

The larynx is located in the neck. The "Adam's apple," seen most prominently on men, forms the front of the larynx. The vocal folds extend back from the Adam's apple.

How is voice produced?

Air passes from the lungs through the larynx when you exhale. Generally there is no sound made by this simple act of breathing. By closing the vocal folds like a valve, the air passes gently between them, vibrating the folds and producing voice.

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What is a "normal" voice?

A normal voice is judged according to whether the pitch, loudness, and quality are adequate for communication and suit a particular person. A person may use a pitch which is too high or too deep, too loud or too soft, too hoarse, breathy, or nasal. Sometimes a voice may seem inappropriate for an individual, such as a high-pitched voice in an adult male.

What is a "problem" voice?

Voice is a problem when the pitch, loudness, or quality calls attention to itself rather than to what the speaker is saying. It is also a problem if the speaker experiences pain or discomfort when speaking or singing. 

What causes a voice problem?

There are a variety of causes of voice problems. Persons can become hoarse temporarily by cheering at a baseball game, or an individual can sustain an injury that causes a paralysis of a vocal fold. Misuse of the voice, such as talking too loudly or using a pitch level that is too high or too low, can result in a voice problem. So can an improper breathing pattern. Abuse of the vocal folds through excessive smoking can be damaging to the voice. Other voice disorders occur without apparent cause and are thought to be neurologic in origin. 

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What are some of the more common conditions related to
voice problems?

Swelling of the folds after voice misuse is known as edema. Small growths that result from misusing the voice are known as vocal nodules, nodes, or polyps.

Can voice problems relating to misuse result in cancer?

Although smoking has been identified as a cause of cancer of the larynx, faulty use of the voice is more likely to cause nodules, nodes and polyps, or contact ulcers. Voice changes can be a sign of cancer and a doctor should be consulted.

What is an early sign of a voice problem requiring professional help?

If you have hoarseness, voice change, or discomfort that lasts for more than ten days in the absence of an allergy or cold, you should have an examination by a medical doctor. This examination will help you decide whether your problem will require professional assistance.

How can voice problems be helped?

Many problems improve dramatically with the help of a speech-language pathologist. Some problems can profit by a combination of medical or surgical treatment and speech-language pathology service. When faulty use of the voice has caused a condition requiring surgery, the help of a speech-language pathologist will be necessary to avoid a recurrence of the problem. With some conditions, such as cancer of the larynx, a laryngologist may recommend surgery and pre-surgical counseling with a speech-language pathologist.

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What is a speech-language pathologist?

A speech-language pathologist is the professional who is trained at the master's or doctoral level to perform the non-medical evaluation of a voice disorder and, when indicated, execute a plan to improve voice. The speech-language pathologist will be licensed by the state of NJ and will hold certification (CCC) from the American Speech-Language-Hearing Association.

How can I decide which is the most appropriate kind of help?

You will want to consult with both the laryngologist and the speech-language pathologist since lasting voice improvement is generally the result of a team approach. 

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