Vocal Cords and Voice Disorders

What are vocal cords?

The vocal cords (also known as vocal folds) are two elastic bands of muscle tissue and ligaments covered with a mucus membrane (mucosa). They are located in the larynx, or voice box, directly above the trachea (windpipe). The vocal cords produce the sound of your voice when air held in the lungs is released and passed through the closed vocal cords, causing them to vibrate. When you are not speaking, the vocal cords remain apart to allow you to breathe.

Vocal cord problems

Dysphonia

Dysphonia is defined as any abnormality of the voice. It may be caused by:

  • Lesions on the vocal cords
  • Problems moving the vocal cords, or vocal cord paralysis
  • Spasms or spasmodic dysphonia is a voice disorder characterized by intermittent, involuntary spasms of the muscles of the larynx while talking or making any kind of vocal sound.
  • Overuse, emotional stress, trauma or illness such as laryngitis

The most commonly used word to describe an abnormal voice is hoarseness. However, hoarseness is a general term that may not have the same meaning to all who use it. We often use the word hoarse to describe any voice abnormality. Laryngologists prefer to be more specific, using words such as harsh, breathy, rough, strained or pressed.

Vocal cord nodules

People who use their voices a great deal, such as professional singers, teachers, auctioneers, lecturers, and members of the clergy, are prone to have nodules on their vocal cords. A vocal cord nodule is a small, inflammatory or fibrous growth that develops on the vocal cords of people who constantly strain their voices.

A nodule is a growth of the epithelium (mucous membrane). It’s similar in structure to a corn on a toe or a callus on the hand. If one has vocal cord nodules, the voice will become breathy and hoarse. Resting the vocal cords by allowing little or no speaking for several weeks may permit the nodules to shrink. Children occasionally have screamer's vocal cord nodules and these can be treated by voice therapy alone.

If surgery is necessary, nodules are removed with direct laryngoscopy. During this procedure, a metal tube with a light on the end of it is inserted in the throat while the patient is under general anesthesia (asleep). The nodule is removed using tiny instruments, including cups, scissors and knives. The removed tissue is sent to a pathologist to rule out cancer. Surgery should be followed by voice therapy to correct the underlying cause.

Vocal cord polyps

A vocal cord polyp is a small swelling in the mucous membranes covering the vocal cords. As they grow, they take on a rounded shape. They may run the whole length of the vocal cords or be localized. Polyps can develop from:

  • Chronic inhalation of irritants (like industrial fumes and cigarette smoke)
  • Chronic laryngeal allergic reactions
  • Hypothyroidism
  • Voice abuse

Polyps can make your voice become breathy-sounding and harsh. Your physician may recommend indirect laryngoscopy to examine your vocal cords.

Other vocal cord problems and voice disorders

There are a variety of disorders that can affect the voice and throat. Henry Ford Laryngologists are trained to provide care for:

  • Speech Language Disorders

    The Henry Ford Division of Speech-Language Sciences and Disorders is certified by the American Speech-Language-Hearing Association to offer you state-of-the-art assessment and treatment of communication and swallowing disorders.

  • Adult Neurogenic Disorders

    These include stroke, Parkinson’s disease, dementia, Alzheimer’s disease, multiple sclerosis, brain tumors and traumatic brain injury.

  • Pediatric Speech and Language Disorders

    These are problems with communication and related areas such as oral motor function. Signs and symptoms range from:

    • Simple sound substitutions, deviations and/or omissions
    • Inability to comprehend or use language
    • Inability or difficulty using the oral-motor mechanism for functional speech and feeding

    Causes may include known factors such as hearing loss, neurological disorders, brain injury, mental retardation and drug abuse. Frequently, however, the cause is unknown.

  • Voice Disorders

    Voice disorders are caused by benign vocal cord lesions, head and neck cancer, psychogenic problems, or neurological illness. Our speech therapists specialize in rehabilitation after a total or partial laryngectomy (removal of all or part of the larynx because of cancer).

    Henry Ford’s Voice Laboratory makes state-of-the-art equipment available for measurement of your vocal cord function. Available tests include:

    • Acoustic analysis of the voice signal
    • Air pressure and flow measurement
    • Laryngeal videostroboscopy

    We also have specialized technology available for those requiring augmented communication because of amyotrophic lateral sclerosis, head injury, or other severely restricted oral communication abilities.

  • Fluency Disorders

    Evaluation and therapy services are available for children and adults who stutter. Services may be arranged on an individual and small group basis.

  • Swallowing Disorders

    Swallowing problems may have various causes, including:

    • Stroke
    • Head injury
    • Head and neck cancer
    • Progressive neuromuscular diseases

    Whatever the cause, our specialists are trained to diagnose and treat a range of swallowing problems.

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