Korea Medical Hub: What is functional dysphonia?

Definition >>

Functional dysphonia is the abnormal use of voice despite normal anatomy and function of the vocal folds and the larynx which produce the voice and the pharynx and mouth which produce resonances. This condition can be related to the abuse or misuse of voice or habituation of compensatory techniques developed from the condition of the larynx.

Classification>>

Functional Dysphonia is often classified into 5 types.
- Conversion aphonia
- Habituated hoarseness
- Inappropriate falsetto
- Vocal misuse/abuse syndrome
- Postoperative dysphonia
- Relapsing aphonia

* Conversion aphonia

It is a dysphonia caused by conversion which is a psychiatric disorder. It is caused by the loss of voluntary control ability due to environmental stress of impairment in social areas. The symptoms include loss or impairment of speech, and dramatic improvements of voice can be brought through psychological treatment.

* Habituated hoarsenessIt is a voice disorder or impairment which appears continuously after an acute laryngitis or a vocal fold surgery while the vocal fold system is normal and has no complications. Although it is sometimes related to laryngopharyngeal reflux, it is more often caused by the social desire to be compensated.

The voice may sound raspy, strained, breathy, or there may be changes in volume or pitch. Treatments include voice therapies using masking sounds, asymptomatic attack, or yawning. About 63% of the cases can be treated by voice therapy.

* Inappropriate falsettoFalsetto voice is when a person makes a very high-pitched voice even in usual conversations. This voice is made from thin vocal lips or excessive contact of the arytenoids cartilages.

About 86% can be treated with voice therapy.

* Vocal misuse/abuse syndromeVocal abuse is any behavior or occurrence that strains or injures the vocal folds. Vocal misuse is improper voice usage such as speaking too loudly or at an abnormally high or low pitch. Frequent vocal abuse and misuse can damage the vocal folds and cause temporary or permanent changes in vocal function, voice quality, and possible loss of voice.

In order to maintain good vocal hygiene, avoid speaking in loud places and rest the voice completely through a counseling program.

* Postoperative dysphoniaIt is a severe voice disorder after vocal fold surgery while there is no abnormality in the vocal folds. Patients with postoperative dysphonia feel a pain when speaking and are easily exhausted. The voice sounds rough and low-pitched.

Patients should be instructed not to abuse or misuse the voice and prevent frequent coughing or gastroesophageal reflux.

* Relapsing aphoniaRelapsing aphonia is a voice disorder which involves severe symptoms of dysphonia or continuous silence. It is often related to undesired happenings or events and is caused by environmental stress or social relations. It has no following symptoms, and the symptoms may get better or worse depending on the mental or psychological state of the patient.

Unlike conversion dysphonia, relapsing aphonia is chronic and relapsing, and does not react to voice therapy. Treatment should involve a psychologist if necessary.