Voice Problems & Disorders

Understanding Voice Problems & Disorders

A healthy voice is key to communication and our ability to connect with others. Our expert team evaluates and treats a variety of voice disorders and conditions that impact quality of life. We offer treatment at the IU Health Voice Center in Carmel, as well as at the IU Health Neuroscience Center in Indianapolis.

Vocal cord paralysis

Vocal cords must open to breathe, then close completely to produce a normal voice and cough. Weakness or paralysis in a vocal cord means there is nerve damage limiting or restricting movement.

This can cause a “breathy” voice, weak cough and difficulty swallowing. Vocal cord paralysis can be caused by a virus, trauma to the voice box or thyroid, spine, neck or chest surgery.

Vocal cord paralysis treatment

Our specialists use an advanced technique called laryngeal electromyography (LEMG). With this technique, we evaluate the extent of your vocal cord injury. We’ll determine whether the nerves will “heal” over time or if they need treatment.

Sometimes we can treat vocal cord paralysis with voice and swallowing therapy. Other treatment options include vocal cord injections. These are performed same day, in the office. The injections strengthen the voice and cough, while improving swallowing.

In some cases, a permanent voice box implant is recommended. This surgery is called a thyroplasty. The voice box implant repositions the vocal cord so that normal voice, cough and swallowing return.

Our physicians also use leading-edge laryngeal reinnervation surgery. This surgery targets and repairs the injured nerves in the voice box to treat vocal cord paralysis.

Papilloma

Papillomas are non-cancerous growths that form in the mouth, cheeks, throat or larynx (voice box). They are typically caused by a viral infection (human papilloma virus, or HPV).

Papilloma growth on the vocal cords typically causes hoarseness. It can also lead to difficulty breathing and swallowing.

Papilloma treatment

We use the most advanced laser treatments to remove papillomas. Many of these procedures can be completed in the office, while you are awake. This allows for faster recovery and avoiding the operating room.

Laryngeal dysplasia

Laryngeal dysplasia is a pre-cancerous growth on the voice box. If you have this condition, you may experience hoarseness or voice changes.

Dysplasia describes an abnormal change in cells that is not cancer, but could lead to cancer. In the voice box (specifically on the vocal cords), dysplasia is visible with a scope as a white plaque. It is called leukoplakia and should be tested to rule out cancer.

Laryngeal dysplasia treatment

Pre-cancerous growths on the voice box are often overtreated with radiation therapy. However, your capacity to receive radiation is limited, especially to the voice box. Because of this, our specialists recommend treating the majority of pre-cancerous growths with advanced laser surgery. This is highly effective in preventing the disease from progressing.

Benign vocal cord lesions

There are a variety of benign (non-cancerous) vocal cord lesions. These include:

• Cysts
• Granuloma
• Nodules
• Polyps

With a variety of causes, these benign lesions can result in hoarseness, a raspy voice, difficulty with higher pitches or reduced vocal range and poor pitch control.

Benign vocal cord lesions treatment

While some benign vocal cord conditions can be treated with voice rest and therapy, surgery is often required to remove the lesions. We use the latest surgical techniques designed to achieve the best voice outcomes.

After surgery, our speech pathology team will work closely with you to help speed recovery and the return of a healthy voice.

Spasmodic dysphonia

If you have spasmodic dysphonia, you have overly active muscles that either close the vocal cords or open the vocal cords. Sometimes individuals have both. With this condition, the voice is often strained or breathy.

Spasmodic dysphonia treatment

Our physicians treat most spasmodic dysphonia with Botox injections into either the vocal cords or the muscles surrounding the vocal cords. Our physicians are trained in multiple techniques to perform these injections to ensure a good result and to keep you comfortable during the procedure. We also partner with neurology physicians at IU Health who help us achieve superior results even in the most challenging cases.

Other voice disorders we treat include:

• Amyloidosis (protein buildup in larynx or vocal cords)
• Laryngeal cancer
• Dysphonia (hoarseness)
• Laryngeal stenosis (scarring between the vocal cords)
• Laryngitis
• Laryngopharyngeal reflux
• Muscle tension dysphonia
• Granulomatosis with polyangiitis (Wegener’s Granulomatosis, chronic inflammatory disorder)
• Puberphonia (high-pitched voice after puberty)
• Sarcoidosis (laryngeal inflammation)
• Reinke’s edema
• Vocal fold scarring

Care for the professional voice

While maintaining a strong, healthy voice is important for everyone, people who use their voice professionally—singers, performers, teachers, lawyers, those in the ministry and other professional speakers—have a specific interest in keeping their voices healthy.

Our team of experienced laryngologists and speech language and voice therapists offer a level of service and expertise that’s unmatched in the state and region.

Whether you’re looking to maintain a healthy voice or treat a voice-related concern, our specialists are uniquely qualified to meet your needs.

Why Choose IU Health?

Our laryngologists are leaders in evaluating and treating issues and conditions that affect the voice, breathing and swallowing. At our Carmel and Indianapolis locations, you’ll have access to the following:

• Board certified, fellowship-trained laryngologists (experts in injuries and illnesses of the larynx). They are sub-specialists within the field of head and neck surgery. They focus on the expert evaluation of throat and neck disorders.
• Speech language pathologists specially trained in the latest therapy techniques.

Our experts are leaders in the field:

• We perform more laryngeal and vocal cord surgeries than any other center in the state.
• Our physicians are engaged in clinical research. This includes studies funded by the National Institutes of Health (NIH), to investigate and develop better treatments for patients.
• We partner with other IU Health specialists, including colleagues at the IU Health Simon Cancer Center and the IU Health Schwarz Cancer Center, to provide the latest treatment for patients.
• We offer vocal rehabilitation, therapy and treatment for people who use their voices professionally. This includes singers, performers, teachers, lawyers, those in the ministry and other professional speakers.