Vocal Hypertension (VH) is one of the most common types of voice disorders. It is a chronic condition caused by the abuse or misuse of the vocal mechanism (larynx or voice box) due to excessive and/or unbalanced muscular forces. The muscles of the larynx work too hard when speaking. It commonly occurs in women, the middle aged people and individuals with high levels of stress, singers and teachers.

Symptoms of Vocal Hyperfunction

The primary symptom of vocal Hyperfunction includes involuntary changes in the quality, pitch or volume of voice.  You need more vocal effort while speaking. Some other symptoms include:

• Fatigue after long periods of speaking
• Running out of breath quickly
• Frequent coughing or throat clearing
• Pain or tenderness in the throat or larynx

Causes of Vocal Hyperfunction

It is assumed that personal temperament, increased vocal use, and underlying medical or physical causes work behind the development of vocal Hyperfunction. The increased tension in laryngeal muscles due to stress causes Vocal Hyperfunction. Those who have to use their voice too much like teachers and singers develop vocal Hyperfunction easily. Again incorrect use of the voice can cause increased tension in the muscle of larynx resulting in Vocal Hyperfunction.

Other causes include:

• A change in vocal fold mucosa resulting in increased tension in the larynx.
• Laryngopharyngeal reflux often brings stomach acid into the larynx. In turn, the larynx gets tensed to prevent the aspiration of the acid.
• Postmenopausal women develop vocal Hyperfunction due to decreased hormone levels which lead to swelling of the laryngeal tissues.
• In older men vocal Hyperfunction occurs as their vocal cords become thin with age.
• Laryngitis is another cause that creates muscle tension.

Diagnosis of Vocal Hyperfunction

If you experience a change in your voice, you must consult an ENT specialist to diagnose the problem. To feel the increased muscle tension of the paralaryngeal and laryngeal muscles, palpation is the most effective diagnostic procedure. Listening to your hoarse and breathy voice, the doctor can diagnose the problem. Voice Quality Index helps measuring voice frequency (high and low), maximum phonation time (MPT), and jitter (frequency instability).

Using Videostroboscopy, a non invasive procedure, the doctor can check the condition of larynx and vocal cords. Stroboscopy helps in visualizing vocal cord vibration and vocal fold closure. These vibrations are too quick to perceive in naked eye. If Stroboscopy finds a posterior Glottic Gap, it surely confirms vocal Hyperfunction.

Surface Electromyography (sEMG) is another diagnosing tool to detect Vocal Hyperfunction. This test reads the muscle units of the muscles of the larynx to deduce if there is increased activity. The increased muscle activities indicate that they are more tensed.

Treatment for Vocal Hyperfunction

Voice therapy is the most effective treatment for Vocal Hyperfunction. The speech-language therapist will guide you to use your voice in a certain way so it decreases the tension of the laryngeal muscles. Voice therapy includes voice exercise to increase Glottic closure and improve vocal hygiene. Following your symptoms and conditions, the therapist may recommend for manual laryngeal therapy, respiratory exercises, nasal exercises and frequency modulation techniques.

Usually, surgery is not needed for Vocal Hyperfunction.

About CURA

CURA, Multispeciality Hospital is very much equipped with recent technology and tools and equipments to conduct all sorts of ENT tests and surgeries in its ultra- modern laboratories and OTs. The ENT specialists and technicians at CURA are most efficient in using these modern tools and techniques for diagnosing and treating ENT ailments. So far our ENT specialists have performed numerous surgeries that yield 100% success. For any kind of ENT issues feel safe at the hands of our Otorhinolaryngologists.