The first thing I have to explain to you is the difference between aphonia and dysphonia. The first is a total loss of voice and I assume that is not what you are referring to in the email you sent us. Probably what happens to you sometimes in the morning is that you have a voice that you don’t consider your normal voice. There is no perfect definition of dysphonia because it is an alteration of vocal perception. And the voice is very different depending on the cultures, the emotional situation, or where you have to project it. This means that telling a voice that it is normal is very difficult. We can say that a voice is normal when it has a pleasant timbre, a tone appropriate for its age range and sex, and an appropriate volume.

The important thing is that dysphonia is a symptom that may or may not be an expression of a local disease, of the vocal cords themselves, or may be due to other systemic diseases. An alteration in the voice has more impact on the quality of life in some people than in others, a dysphonia in a voice professional (singers, teachers, telemarketers, radio announcers) is not the same as in a person who does not require the voice as a work tool.

The voice is complex, but it is produced by the vibration of muscles called vocal cords. The reader who consults us should be asked more questions such as age, if he suffers from other accompanying symptoms such as itching or burning, if he has a history of gastroesophageal reflux, his vocal habits and, what is very important, if he is a smoker. Furthermore, it is relevant within dysphonia to know if the patient suffers from any other disease or has had any cervical surgery.

Dysphonias are divided into functional ones, which is what probably happens to our reader if he then recovers his voice throughout the day, and organic ones, which occur because there is an injury. In both cases, both the diagnosis and the treatment are totally different.

Organic lesions are frequently caused by misuse or abuse of the voice. It is something that happens to many teachers who develop nodules because they have not had vocal training and in the end an injury occurs that produces dysphonia. Generally, voice professionals have learned to handle their work instrument. However, many teleoperators, teachers, etc., have not received training and due to misuse and/or abuse of their voice they begin with organic lesions such as nodules, polyps or edema that lead to increasingly frequent and intense episodes of dysphonia.

Not only misuse causes injuries, tobacco is an important factor in dysphonia. And there are congenital injuries that also cause the vocal cords to function poorly from birth and can ultimately lead to injury. Habitual pharyngolaryngeal reflux can also cause injury to the vocal cords, and many other diseases such as some neurological or endocrine pathologies. The most common thing is to have dysphonia within the context of a cold process and these subside following improving the cold, resting the voice and hydrating. We have all gone out to party and had dysphonia that has improved following vocal rest. In short, to treat dysphonia, we must know the cause that produced it and treat it.

If it is tobacco, quit smoking. If it is reflux, take hygienic-dietary measures such as giving up caffeine, giving up alcohol, not having heavy dinners, etc. If you misuse your voice while teaching or coaching a soccer team, you have to know that you must warm up your vocal cords beforehand, you have to pause in your speech, do relaxation exercises and not raise your tone above your capabilities. We must be aware that each person’s muscles are different and the voice is a muscular capacity. One can talk a lot and never have dysphonia and another can talk very little and still suffer from it. This explains that not all people can be sopranos, just as not all of us can run a marathon.

In summary, to avoid dysphonia you must know the cause that motivates it. Although it may seem like the same symptom, an abnormal voice, the treatment of this alteration can be totally different: it may require medical, surgical and/or speech therapy treatment. It is important to know that dysphonia that is not cured in 15 days by performing vocal rest, and especially in patients with risk factors such as smoking, should be evaluated by a specialist in otorhinolaryngology because it can be a symptom of a serious illness such as cancer. or a neurological pathology.

Elisa Gil-Carcedo She is head of the Otorhinolaryngologist section at the Río Hortega University Hospital and Associate Professor at the Faculty of Medicine of the University of Valladolid.

Question sent via email byLeonardo Fernandez.

Coordination and writing: Victoria Toro.

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The advice of this office is of a general nature and does not replace medical consultation. If you have questions regarding your specific problem, contact your health professional.