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Basics of Voice Disorders

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Phoniatrics I

Part of the book series: European Manual of Medicine ((EUROMANUAL))

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Abstract

The chapter starts with the traditional definition of voice disorders based on main symptoms (hoarseness, limited laryngeal efficiency or vocal endurance, sensations of laryngeal discomfort) and systematic aetiological classification (organic-functional), whereas for ‘functional’, the alternative term ‘malregulative’ is recommended. Relevant parameters of voice production are presented in terms of a clinical and an acoustical setting as a basis for a plausible terminology. The long-lasting controversial discussion on vocal registers is objectified by associating subjective sensations and metaphorical interpretations with underlying mechanisms and typical physiological correlates. Another special view refers to the role of the external laryngeal muscles in voice production. Exact epidemiological data about specific types of voice disorders are still rare. Voice disorders are common in all age groups and in both sexes, with one third of the general population said to experience a voice problem once in their lifetime. The higher the voice load, the higher is the risk of developing a voice problem. An overview of pathology and pathogenesis of dysphonia focuses on malformations, inflammation, systemic diseases, malignancies and traumata affecting the larynx, resonance disorders and presbylaryngis. Current knowledge about the genetics of voice disorders is presented, covering vocal fold microstructure, vocal fold diseases, voice-related genetic syndromes and genetic neurological diseases. The genetic treatment approaches include tissue engineering, the use of technology tools and personalised medicine. A final section on the pathophysiology of voice production concentrates on manifestations such as hoarseness, roughness and breathiness, as well as on the influences of subglottal pressure, transglottal airflow and the supraglottal part of the vocal tract.

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Notes

  1. 1.

    ‘Dysphonia’ or ‘phonatory disorder’ is the more precise phrase because ‘voice disorder’ merely indicates the product ‘voice’ rather than the complex phonatory function.

  2. 2.

    In order that clarity be preserved, this classification does not include the level of cell regulation.

  3. 3.

    Suggested by Pahn and Friemert (<CitationRef CitationID="CR101" >1988</Citation Ref>).

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Author information

Authors and Affiliations

  1. Department of Otolaryngology, Yeditepe University, Istanbul, Turkey

    Sevtap Akbulut

  2. Clinic of Phoniatrics and Pedaudiology, University Hospital Münster, Münster, Germany

    Antoinette am Zehnhoff-Dinnesen & Amélie Elisabeth Tillmanns

  3. Research Group ExpORL, University Hospitals, KU Leuven, Leuven, Belgium

    Felix de Jong

  4. Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, Munich University Hospital (LMU), Campus Großhadern, Munich, Germany

    Matthias Echternach

  5. Department of Medical Physics and Acoustics/Medical Physics and Cluster of Excellence Hearing4all, Carl von Ossietzky-Universität Oldenburg, Oldenburg, Germany

    Ulrich Eysholdt

  6. Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany

    Michael Fuchs

  7. Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University Budapest, Budapest, Hungary

    Tamás Hacki

  8. Department of Otolaryngology, Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    Krzysztof Izdebski

  9. Voice Care Center Bad Rappenau, Bad Rappenau, Germany

    Annerose Keilmann

  10. Phoniatrics and Pediatric Audiology, University Hospital Regensburg, Regensburg, Germany

    Peter Kummer

  11. Voice Unit, The Medical Center, Copenhagen, Denmark

    Sanila Mahmood & Mette Pedersen

  12. Division of Phoniatrics and Audiology and Saxonian Cochlear Implant Center, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    Willy Mattheus & Dirk Mürbe

  13. Department of Audiology and Phoniatrics, Charité—University Medicine Berlin, Berlin, Germany

    Tadeus Nawka

  14. Fonomer, Ankara, Turkey

    Haldun Oguz

  15. Phoniatrics Department, Federal Research Clinical Centre of Otorhinolaryngology, Moscow, Russia

    Ekaterina Osipenko

  16. ENT Department, Municipal Hospital Dresden, Dresden, Germany

    Friedemann Pabst

  17. Department of Phoniatrics and Pediatric Audiology, University Clinic of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany

    Rainer Schönweiler

  18. Department of Otolaryngology and Phoniatrics – Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland

    Erkki Vilkman

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Editor information

Editors and Affiliations

  1. Clinic of Phoniatrics, University Hospital Münster, Münster, Germany

    Antoinette am Zehnhoff-Dinnesen

  2. Department of Phoniatrics and Audiology, University of Medical Sciences, Poznan, Poland

    Bozena Wiskirska-Woznica

  3. St. Elisabeth-Hospital, Abt. für Phoniatrie und Pädaudiologie, Ruhr University Bochum HNO-Universitätsklinik, Bochum, Germany

    Katrin Neumann

  4. Klinik für Audiologie und Phoniatrie, Charité - Universitätsmedizin Berlin Campus Charité Mitte, Berlin, Germany

    Tadeus Nawka

1 Electronic Supplementary Material

Case Study Audio Sample 4.1

Breathy voice (MP3 1895 kb)

Case Study Image 4.1

Voice range profile breathy voice (JPG 181 kb)

Case Study Audio Sample 4.2

Normal male voice (MP3 1850 kb)

Case Study Image 4.2

Voice range profile normal male voice (JPG 187 kb)

Case Study Audio Sample 4.3

Normal female voice (MP3 4490 kb)

Case Study Image 4.3

Voice range profile normal female voice (JPG 180 kb)

Case Study Audio Sample 4.4

Rough voice (MP3 1621 kb)

Case Study Image 4.4

Voice range profile rough voice (JPG 164 kb)

Case Study Audio Sample 4.5

Ventricular fold voice woman (MP3 2261 kb)

Case Study Image 4.5

Voice range profile ventricular fold voice woman (JPG 179 kb)

Case Study Audio Sample 4.6

Vocal sound louis armstrong (MP3 1908 kb)

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Akbulut, S. et al. (2020). Basics of Voice Disorders. In: am Zehnhoff-Dinnesen, A., Wiskirska-Woznica, B., Neumann, K., Nawka, T. (eds) Phoniatrics I. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46780-0_4

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