Overview of A Voice Disorder and Other Variables

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Voice disorders can be categorized by the following subtypes:

Organic—physiological voice disorders that result from alterations in respiratory, laryngeal, or vocal tract mechanisms.
- Structural—organic voice disorders that result from physical changes in the vocal mechanism, such as
  - alterations in vocal fold tissues (e.g., edema or vocal nodules) and/or
  - structural changes in the larynx due to aging.
- Neurogenic—organic voice disorders that result from problems with the central or peripheral nervous system innervation to the larynx that affect functioning of the vocal mechanism, such as
  - vocal tremor,
  - spasmodic dysphonia, or
  - vocal fold paralysis.
Functional—voice disorders that result from inefficient use of the vocal mechanism when the physical structure is normal, such as
- vocal fatigue,
- muscle tension dysphonia or aphonia,
- diplophonia, or
- ventricular phonation.

The recovery process

Voice quality can also be affected when psychological stressors lead to habitual, maladaptive aphonia or dysphonia. The resulting voice disorders are referred to as psychogenic voice disorders or psychogenic conversion aphonia/dysphonia (Stemple et al., 2010). These voice disorders are rare. Speech-language pathologists (SLPs) may refer individuals suspected of having a psychogenic voice disorder to other appropriate professionals (e.g., psychologist and/or psychiatrist) for diagnosis and may collaborate in subsequent behavioral treatment.

The complementary relationships among these organic, functional, and psychogenic influences ensure that many voice disorders will have contributions from more than one etiologic factor (Stemple et al., 2014; Verdolini et al., 2006). For example, vocal fold nodules may result from behavioral voice misuse (functional etiology). However, the voice misuse results in repeated trauma to the vocal folds, which may then lead to structural (organic) changes to the vocal fold tissue.