Voice and Resonance Disorders

Voice Disorders

The vocal cords in the larynx (voice-box) vibrate to produce sound. If one or both vocal cords are not working the right way, we will have voice problems. Voice disorders include problems with the pitch, volume or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort while speaking. One may also experience difficulty in swallowing and/or breathing.


The causes of voice disorders can be varied. Infection, injury, paralysis or tumors of the larynx (voice box) may result in a hoarse, breathy or painful voice. Voice abuse and misuse may also lead to the formation of vocal nodules, polyps or cysts. It is estimated that about 3 to 10 percent of individuals experience some kind of voice problem at a given moment of time. The vast majority of voice problems are caused by factors that are not life-threatening and that are easily treatable.

Anyone can develop a voice problem but a person is at a high risk if his / her job puts a great demand on the vocal cords. About 25 percent of population engages in work that is “vocally demanding”. Amongst the most frequently seen professions with voice disorders are teachers, singers, attorneys, actors, sales representatives, receptionists, technical support and customer service personnel. Also, there are people who use their voice in noisy environments. These include restaurant workers, factory or machine workers, and police officers who are vulnerable to voice difficulties.

Signs and Symptoms:

You must consult Ms. Kothari at Let’s Talk Speech Therapy if:
  • Your voice is hoarse, harsh or rough and sounds different to you
  • If it is painful to talk for more than 2-3 weeks
  • You lose your voice easily when talking
  • You have to work hard to speak loudly enough to be heard
  • You experience difficulty or pain while swallowing

Evaluation and Treatment:

Ms. Kothari will carry out a comprehensive evaluation to assess different parameters of your vocal quality/ voice. Once the underlying cause of the disorder is determined, a comprehensive individualized voice therapy (treatment plan) is developed. It is designed to re-strengthen and re-balance your laryngeal mechanism.
Voice therapy is the first line of treatment for vocal fold lesions like vocal nodules, polyps, or cysts. It can help to reduce the severity and can even allow damaged vocal cords to heal without surgery.

In the past, focus of communication treatment was on those severely affected. However, today, as more people rely on their ability to communicate for their livelihood, treatment of such disorders becomes more important.

Resonance Disorders

Resonance disorders may result because of various structural abnormalities in the resonating chambers, or secondary to velopharyngeal dysfunction. These abnormalities may result in hypernasality, hypo- or denasality, or cul-de-sac resonance; depending on the type of problem.


Resonance disorders are commonly seen in patients with craniofacial anomalies, such as cleft lip/ palate. Adenoids, nasal polyps and deviated septum may result in hypo nasality.

Signs & Symptoms:

  • Hyper nasality (Excess Nasal Resonance).
  • Hypo nasality (Reduced Nasal Resonance).
  • Audible nasal air emission.
  • Weak or omitted consonants.
  • Short utterance length.
  • Distorted speech sound production.

Evaluation and Treatment:

Besides, Speech pathology evaluation, one may require a video-fluoroscopic speech study or nasopharyngoscopy assessment. Treatment may include surgery or the use of prosthetic devices, and speech therapy. At Let’s Talk Speech Therapy various oro motor tools are used to develop muscle strength and facilitate appropriate velopharyngeal closure.