Functional Voice Disorders
The most common voice disorder, caused by using too much muscular effort to phonate.
MTD
Bilateral, symmetrical, callous-like lesions at the mid-membranous folds from phonotrauma
Nodules
Strained-strangled voice with voiced arrests, worst on all-voiced sentences.
Adductor spasmodic dysphonia (ADSD)
The sensation of a lump in the throat, associated with reflux and a throat-clearing cycle.
Globus
The three-category system for classifying voice disorders.
Functional, organic, and neurogenic
This subtype of MTD is compensatory to an underlying condition.
Secondary MTD
Usually unilateral and often fluid-filled, this lesion frequently follows a single traumatic vocal event.
Polyp
Breathy breaks on voiceless consonants.
Abductor spasmodic dysphonia (ABSD)
The glottic closure pattern produced by atrophic or bowed vocal folds.
Spindle closure
Classification matters because it guides these three clinical decisions.
Differential diagnosis, referral, and treatment
A persistently high-pitched voice in a post-pubertal male with a structurally normal larynx
Puberphonia (mutational falsetto)
Diffuse, fluid-filled swelling of the superficial lamina propria strongly linked to smoking.
Reinke's edema
Rhythmic 4–7 Hz modulation of pitch and loudness during sustained phonation.
Essential vocal tremor
The rippling of mucosa across the fold, reduced or absent over a stiff lesion.
Mucosal wave
A vocal fold cyst falls in this category; essential tremor falls in this one.
Organic and neurogenic
Complete loss of voice from emotional trauma, in which the patient still whispers and coughs normally.
Psychogenic (conversion) aphonia
An HPV-caused lesion that recurs and requires repeated surgical removal.
Recurrent respiratory papilloma
Breathy, weak voice with reduced loudness and aspiration risk, or no s/s of dysphonia, from one immobile fold.
Unilateral vocal fold paralysis (UVFP)
Name two perceptual signs of UVFP.
Breathiness, reduced loudness, diplophonia, short MPT, vocal fatigue...
Secondary MTD blurs the categories because the muscle tension is this.
Compensatory
Because the symptoms have no physical cause, resolving a psychogenic voice disorder usually requires this alongside voice therapy.
Counseling / psychotherapy
This "silent" backflow of stomach contents irritates the larynx, can cause throat clearing and posterior granuloma.
Laryngopharyngeal reflux (LPR)
Reduced loudness, monopitch, and breathy quality in Parkinson's disease, targeted by LSVT LOUD.
Hypophonia
The auditory perceptual attribute of noise or air in the sound.
Breathiness
The SD task battery uses falsetto and singing because ADSD and psychogenic voice often do this in those conditions.
Normalize / improve