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Frequently Asked Questions About Voice Disorders

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If you have a vocal problem, you might experience symptoms such as:

  • Breathiness
  • Hoarseness
  • Dryness
  • Pitch problems
  • Shortness of breath
  • Inability to sing softly
  • Breaks in the voice
  • Pain when using voice
  • Poor quality of voice

People who use their voices a lot or those who work in noisy environments are at a greater risk for developing vocal problems.


Professions at higher risk for getting voice disorders include:

  • Singers
  • Actors
  • Teachers
  • Attorneys
  • Sales representatives
  • Receptionists
  • Phone support personnel

If you experience hoarseness or a voice change that persists more than one week without improvement — or lasts more than two weeks — you should see your doctor.


If you experience difficulty swallowing or breathing, see your doctor immediately.

A number of items can cause problems in the larynx (voice box), including:

  • Nicotine and cigarette smoke
  • Marijuana
  • Antihistamines
  • Aspirin
  • Anything that dulls perception (alcohol, Valium)
  • Thyroid drugs
  • Birth control pills (estrogens)
  • Hypertension drugs
  • Steroids



Smoking and exposure to cigarette smoke irritates and dries the lining of the voice box, thereby:

  • Decreasing voice quality
  • Promoting reflux laryngitis
  • Increasing the need to clear your throat

Smoking also destroys lung function. Without good lung function, singing is impossible and speaking can be difficult.

Yes. Stomach acid can pass up to the throat and irritate the larynx (voice box), negatively affecting voice quality. This condition is called laryngopharyngeal reflux disease (LPRD).


You can help prevent LPRD by changing the time, type, and amount of food you eat, and by avoiding:

  • Alcohol
  • Mint
  • Caffeine

Yes, drinking water is good for your voice. The vocal cords (also called folds) vibrate against each other 100 to 400 times per second and require constant lubrication.


At the UPMC Voice Center, we recommend drinking six to eight glasses of water per day — and avoiding caffeinated drinks such as cola, tea, and coffee — for sufficient vocal lubrication. If you do drink caffeine, you need to drink additional glasses of water.

Singer's nodes, or vocal nodules, are small calluses on the vocal cords. They occur in both boys and girls, but predominately in women.


Nodules come from abuse to the vocal cords associated with:

  • Yelling
  • Screaming
  • An unnatural pitch or singing style

Experts at UPMC's Voice Center can treat vocal nodules quite easily and successfully with voice therapy. Nodules rarely require surgery.

Although smoking is identified as a cause of cancer of the larynx (voice box), misuse of the voice is more likely to cause voice conditions such as:

  • Singer's nodes or vocal nodules
  • Polyps
  • Cysts
  • Contact ulcers

Voice therapy involves a patient-centered treatment method to modify behaviors that contribute to voice disorders or in some other way limit normal voice use.


The two major ways to change vocal behaviors are:

  1. Rigorous application of vocal wellness principles.
  2. A series of therapeutic techniques specifically designed to change the way the vocal folds vibrate and how the vocal tract resonates.

Voice therapy exercises include:

  • Postural adjustments
  • Breathing
  • Specific neck and throat relaxation exercises
  • Exercises to mobilize the muscles of the lips, tongue, and jaw
  • Flow phonation
  • Resonant voice

To establish the necessary behavioral changes for correcting your voice disorder, you will need to attend voice therapy sessions once a week for the first few weeks of treatment.


At the UPMC Voice Center, we can often treat common voice disorders — such as vocal nodules or muscle tension dysphonia — in just four to eight sessions.

Yes. At the UPMC Voice Center, we offer several treatments for vocal cord paralysis that often result in restoring near-normal speaking voice quality.


The most common treatment for a paralyzed vocal cord is voice therapy. Voice therapy helps maximize the voice and compensate for the immobile vocal cord.


Experts at UPMC's Voice Center may also recommend surgery, along with voice therapy, to treat paralyzed vocal cords. We can perform certain surgeries without putting you to sleep, allowing you to go home the same day.

Yes. Many things can cause a weak voice or vocal fatigue (a voice that tires easily).


Depending on the cause, voice therapy often helps strengthen a weak or tired voice.


Surgery on the vocal cords is another treatment option for correcting a weak voice or vocal fatigue. Experts at UPMC's Voice Center can perform vocal fold augmentation surgery to make the vocal cords bigger.