Incorrect voice technique and the harmful stress on the vocal folds often lead to dyskinetic voice disorder. The voice sounds rough or hotter and the patient complains of a scratchy throat or a feeling of pressure in the area of ​​the larynx. Therapeutic measures help to learn the correct vocal technique and to properly load the vocal folds when speaking.

What is dyskinetic voice disorder?

According to Gradinmath, the group of dyskinetic voice disorders includes all functional voice disorders that are not caused by organic damage. Rather, this disorder is triggered by an incorrect vocal technique, an incorrect load on the vocal folds or an overstrained voice. It occurs as hyper- or hypofunctional dysphonia and manifests itself in an altered voice quality.

The voice usually sounds noticeably rough and hoarse. Both children and adults are affected by the disease. However, it often occurs in people who use their voice a lot. A classic example are teachers and educators. After all, these professional groups have to talk long and loudly when the noise level is high. In addition, children who scream more than average are prone to this vocal disorder. It is not uncommon for women to develop vocal cord nodules in the course of the disease.

Causes

Dyskinetic voice disorder has a number of causes. Since it is a functional disorder of the vocal apparatus, however, no organic damage is responsible for the disorder. Most of the time, the tuning tools are only functional to a limited extent.

The most common reason is strong physical stress on the vocal folds, such as those that occur in the event of fright or pain. As a result, the vocal folds do not arrange themselves correctly when speaking (so-called phonation position) or they press tightly together. Hyperfunctional dysphonia is caused by excessive tension in the vocal folds when speaking.

On the other hand, excessive sparing of the vocal folds when speaking leads to hypofunctional dysphonia. There are also harmful influences that put additional strain on the voice and promote dyskinetic voice disorder. These include, for example, alcohol and nicotine, as well as frequent screaming.

Symptoms, ailments & signs

In patients with hyperfunctional dysphonia, the pocket folds are protruding and the epiglottis is noticeably deep. As a result, the vocal cords are close together and the entrance to the larynx is narrowed. On the other hand, hypofunctional dysphonia is noticeable due to a high epiglottis and incompletely adjacent vocal cords.

In addition, in this case the tone holding time is shortened. The affected people usually complain of a feeling of pressure in the larynx area and a scratchy throat. Even the slightest stress on the vocal apparatus dissolves a noticeably hoarse and rough voice. In women, vocal cord nodules also sometimes develop.

Diagnosis

If a dyskinetic disorder is suspected, an ear, nose and throat specialist should be consulted immediately. This first assesses the patient’s voice, because its change is the main symptom of the functional voice disorder. Often it also provides initial information about possible causes of the disorder. The doctor conducts an extensive survey of the person concerned.

Among other things, he informs himself about the job, possible allergies and medication he has taken. This is followed by an examination, whereby the doctor pays attention to the breathing technique, the flow of speech and the use of language. In many cases, the diagnosis is supplemented by methods of laryngoscopy (larynxoscopy) and stroboscopy. They serve to determine or exclude organic damage.

Based on the diagnosis, the doctor initiates the necessary therapeutic measures. As a result, the disease usually takes a positive course. Incorrect use of the voice can be corrected and the dysphonia usually disappears. In children, the voice disorder often goes away on its own. Long-lasting voice problems should also be treated professionally for them.

Complications

Dyskinetic voice disorder is a functional disorder of the speech apparatus. The voice appears hoarse or rough, sometimes with a scratchy throat and discomfort in the larynx. If left untreated, symptoms may worsen.

Dyskinetic voice disorder is sometimes caused by improperly directed vocal technique, overload of the voice or vocal folds. It is helpful to improve your vocal technique to a healthy level in order to reduce the stress on the speaking apparatus. However, excessive underloading of the vocal folds (hypofunctional dysphonia) can also lead to dyskinetic voice disorders.

Voice overexertion affects people who have to speak a lot for work-related reasons. These include teachers, lecturers, educators, singers and telephone operators. Failure to treat the voice disorder can have existential consequences. Children who scream a lot in the day care center can also develop dyskinetic voice disorders.

You have to be taught how to use your voice carefully so that there is no permanent damage to your voice. In the short term, rest or inhalation with hot water will help. In the long term, however, the speaking habits should be changed. First of all, an ENT doctor should be consulted who will involve a speech therapist.

This helps to convey harmonious and economical speech through therapeutic measures in the form of voice training. This includes improving the fluency and use of language as well as breathing exercises under professional guidance. Since alcohol, nicotine and frequent screaming aggravate the symptoms, they should be avoided.

When should you go to the doctor?

If a dyskinetic voice disorder is suspected, it is advisable to see a doctor. A scratchy throat and a feeling of pressure in the larynx are clear warning signs that should be clarified quickly.

This is especially true if the voice problems persist for a long time or other symptoms such as pain, difficulty swallowing or inflammation are added. With children, elderly and sick people as well as patients with an immunodeficiency, the doctor should be consulted immediately in the event of complaints. People who speak little or who overload the vocal folds are particularly at risk of developing dyskinetic voice disorder.

Allergies and medication can also cause problems with the vocal folds. Harmful influences such as nicotine and alcohol are also risk factors and those affected should consult an ear, nose and throat specialist if these factors apply.

In the case of complaints mentioned, the doctor can first make a suspected diagnosis by assessing the patient’s voice and examining it for changes. Based on the diagnosis, the necessary treatment can then be initiated or the patient can be referred to a specialist doctor or a specialist clinic for vocal cord disorders.

Treatment & Therapy

Dysphonia can be treated in different ways. Depending on the cause, surgical or conservative methods are used. Therapeutic measures are preferred. If these are successful, surgery can ultimately be dispensed with. Therapy is often given by a speech therapist. In doing so, the patient learns the correct use of the voice in educational conversations.

He also performs various speech and breathing exercises under professional guidance. They help the affected person to develop a less stressful voice technique. If the patient has stubborn vocal cord nodules, these are surgically removed if the therapy does not work.

Such an operation is followed by another voice therapy. Otherwise, if the voice is used incorrectly, the nodules can form again within a few days. Depending on the severity of the disorder, psychological support is also useful.

Outlook & forecast

Dyskinetic voice disorder has a favorable prognosis. In speech therapy, the patient learns the right techniques for optimal speech. Incorrect strain on the vocal cords, muscles or problems with pronunciation are corrected in various training sessions and exercises. The treatment plan is adapted to the individual needs of the patient. A sense of achievement is encouraged and the joy of speaking is supported.

Without therapy, problems or abnormalities in vocalization often persist for life. In individual cases, the voice disorder worsens or the patient completely refuses to speak. In many cases, there is a decreased volume while speaking, a speech impediment or a persistent accent.

The best prognosis is given to patients who use psychotherapy to support speech therapy. Often language barriers are linked to emotional or psychological barriers. They emerged after trauma, in phases of tough life challenges or through unprocessed emotional processes.

If the dyskinetic voice disorder is triggered by organic problems such as the formation of voice knots, surgery is performed to correct it. After the operation, voice therapy is prescribed immediately, in which the voice is learned again. If this therapy is not used, the voice disorder will recur as lumps repeatedly form.

Prevention

In children, dyskinetic voice disorder can be prevented or detected early. For this purpose, parents should pay attention to the language development of their offspring and prevent frequent screaming. As soon as you notice abnormalities in your voice, you should see a doctor immediately. He can get to the bottom of the cause and initiate appropriate treatments.

Those who work in a voice-intensive profession (for example, educator, teacher or pastor) should also carefully observe their use of the voice and attach great importance to correct vocal technique. It is also advisable to avoid harmful influences such as alcohol and nicotine.

Aftercare

In most cases, the options and measures for direct follow-up care for this disease are severely limited or are not available to the person concerned. First and foremost, a quick and, above all, an early diagnosis should be made so that there are no further complications or further worsening of the symptoms.

Self-healing cannot occur in this disease, so treatment by a doctor must be carried out in any case. In most cases, this disease is treated through various therapies. Those affected usually have to consult a speech therapist, although many of the exercises from such therapies can also be performed in their own home.

This may speed up the healing process for the affected person. Furthermore, the parents should encourage the child with this disease and support it in the treatment in any case. Empathetic and loving conversations are also very useful, so that there are no psychological upsets or depression. The further course depends very much on the exact severity of the disease, so that no general prediction can be made. However, it usually does not reduce the patient’s life expectancy.

You can do that yourself

Dyskinetic voice disorder is a functional voice disorder that is not due to organic causes, but rather to incorrect use of the voice tools. If this disease is suspected, a specialist, preferably an ENT doctor, should be consulted immediately.

After a comprehensive examination of the vocal tools, especially the vocal cords, on which nodules form very quickly, therapeutic measures are recommended to the patient, which he should absolutely observe. In the case of children, it is often enough to encourage them to stop shouting loudly while playing. Parents who cannot assert themselves against their children should quickly seek professional educational help.

It is usually also necessary for adults to spare their voice for some time. This is especially true for professional speakers such as teachers and educators. In the event of dyskinetic voice disorder, this professional group must be prepared for the fact that they will not be able to carry out their activities for some time. Medically prescribed rest periods should be strictly observed.

In addition, it is necessary to learn how to use the voice tools correctly in order to prevent dyskinetic voice disorder from occurring again. As a rule, a speech therapist is called in to perform speech and breathing exercises with those affected and teach them the correct use of the voice. The techniques learned should definitely be used to prevent relapse.