Etiology of voice disorders and treatment of voice disorders

  Voice is a sound produced by using the air exhaled to form vibrations through the body as a resonant cavity. The organs involved in speech and singing are made up of three parts: the articulatory organ: larynx, the organs of speech (sound): larynx, pharynx, lips, teeth, tongue, etc., and the resonant cavities of the body: larynx, chest, pharynx, oral cavity, and nasal cavity. These three parts work together in order for us to speak normally and sing beautifully. Dysfunction of these three parts, on the other hand, can lead to speech disorders, loss of voice, change in pitch, difficulty in articulation, or loss of special vocal abilities (such as singing, etc.).  There are many diseases that may lead to voice disorders, including: 1. inflammation (acute and chronic laryngitis, specific infections such as laryngeal tuberculosis, syphilis, etc.); 2. benign proliferative lesions of the vocal folds (most common, including vocal fold polyps, vocal fold nodules, vocal fold cysts, vocal fold sarcoidosis, etc.); 3. laryngeal neuromuscular dysfunction (such as retrolaryngic nerve palsy, supraglottic nerve palsy, spastic vocal disorder, severe muscle weakness, etc.); 4. Mechanical movement disorders of the vocal folds (the most common is cricoarytenoid dislocation); 5. laryngeal tumors; 6. psychogenic vocal disorders (hysterical loss of voice); 7. physiological vocal disorders (male female voice, female male voice, etc.).  Common causes of voice disorders include: 1. Excessive vocalization, improper use of voice and bad habits: misuse and abuse of voice is the most common cause of many voice disorders. For example, patients often speak in a noisy environment; they like to scream or use their voices without rest for a long time; and the frequency of pronunciation is not appropriate. Bad habits include smoking, alcoholism, staying up late, etc.  2. Infection and inflammation: acute or chronic upper respiratory infection, tonsillitis, laryngitis, sinusitis, bronchitis, etc. can affect the vocal cords and affect the voice.  4, tumors and proliferative diseases: vocal fold tumors, vocal fold polyps, etc.  5, neurogenic diseases: vocal cord paralysis or vocal cord spasm due to nerve disorders that innervate the vocal cords.  6. Trauma: common dislocation of the cricoarytenoid joint and fracture of the larynx.  7. Systemic factors: such as endocrine abnormalities (sex hormone changes, hypo- or hyperthyroidism), reflux laryngitis, and psychogenic factors cause vocal disorders, most commonly in young women, who suddenly lose their voice after emotional or psychological trauma, with normal vocal fold shape. The vocal folds are normal in appearance. The vocal folds are normal in appearance, but the voice is normal when coughing, laughing or yawning.  Many voice disorders can be corrected and cured by conservative treatment. The main treatments include medication, physical therapy and speech correction. Among them, speech correction is an important element. The purpose of speech correction is to correct incorrect vocal habits and methods, and to make the lesions of patients with these voice disorders, gradually fade away, promote mucosal regeneration and restore normal mucosa through non-invasive scientific vocal methods according to different pathological voices. The pharyngeal voice training method proposed by domestic Lin Junqing is an effective method for correcting incorrect vocal training based on the Italian traditional vocal in the American singing method, which is summarized to achieve the relaxation of the larynx and neck muscles and the mediation of breathing breath in a simple, practical and effective way.  Surgical treatment can be considered for certain laryngeal proliferative inflammatory and tumoral lesions as well as movement disorders of the vocal cords. There are several modalities of surgical treatment: microsurgery can be used for benign laryngeal proliferative lesions, precancerous lesions, early laryngeal cancer, laryngeal stenosis, sulcus vocalis and bilateral vocal fold paralysis. This type of surgery is guided by a supported laryngoscope with the application of an operating microscope and microsurgical instruments or laser technology to complete the removal of laryngeal lesions.  For vocal cord motility disorders as well as vocal cord tension disorders, vocal cord injection filling or laryngeal framework surgery can be used. The former involves the injection or filling of autologous or allogeneic biomaterials into different layers of the vocal folds or into the paravocal gaps to improve vocal fold closure and restore the vibratory properties of the vocal folds, depending on the nature of the vocal fold defect. The latter is a procedure that does not affect the characteristics and quality of the vocal folds themselves and does not cause direct damage to the vocal folds, but only changes their position. Compared with other surgical methods, the postoperative voice is closer to the natural voice. The surgery is routinely divided into four types, of which type I is the most performed at home and abroad and has the most reliable results, while the other types are less performed at home and abroad. There are many types of implants, such as medical silicone, titanium clips and hydroxyapatite, which are easy to operate and have very good long-term results.  Theoretically, the best treatment for vocal cord paralysis is to restore the physiological function of the paralyzed larynx through nerve repair. Many scholars have conducted a lot of discussions in this field, but there are relatively few effective and reliable techniques that can be applied to clinical practice, and further improvement is needed.