Low-Volume Voice Disorder: Causes and Treatment Options

Speech is complicated. Your lungs expel air that passes over two folds of tissue (vocal cords) in your larynx (voice box). The air movement triggers a vibration in the cords, and when the folds touch, they produce a sound.

If you have difficulty managing your voice’s pitch, tone, or volume, your vocal cords aren’t vibrating normally — a voice disorder. It may be temporary or permanent, depending on the underlying cause.

At Oasis Ear, Nose, and Throat, Dr. James Osborne and Dr. Bryan Smedley diagnose and treat voice disorders at our office in Surprise, Arizona. If you’re experiencing a low-volume voice disorder, here are some likely culprits and the treatments we use to correct them.

What is a voice disorder?

A voice disorder changes the quality of your natural voice in some way. You may become temporarily hoarse or breathy or sound higher, deeper, or softer than another person of your age and gender.

Voice disorders fall into two main categories:

1. Organic voice disorders

These disorders occur because the structure of your larynx or vocal fold tissues isn’t normal, interfering with sound production. They can also result from certain neurological conditions. In either case, you can’t do much to prevent them, but you can treat them. 

2. Functional voice disorders

These disorders occur because you strain your cords due to excess or improper use, such as loud shouting at a concert or constantly clearing your throat.

Causes of organic voice disorders

Organic voice disorders can result from growths on the cords, such as nodes or polyps; inflammation and swelling from allergies, respiratory illnesses, or acid reflux; medical conditions that affect the nerves controlling the cords, such as multiple sclerosis, ALS, and Parkinson’s disease; or hormone imbalances (e.g., thyroid, estrogen, testosterone, and growth hormones).

Causes of and treatments for low-volume voice disorder

Low-volume voice disorders can come from any of the following conditions:

Laryngitis

When your vocal cords swell, it’s called laryngitis, and it may make your voice hoarse or take it away completely. Acute laryngitis comes on quickly, usually from a virus in the upper respiratory tract. Symptoms last a few weeks; resting your voice and drinking plenty of fluids can help.

Chronic laryngitis is when long-term swelling sets in. Common causes include chronic coughing, using inhalers for asthma, and GERD (acid reflux). Treatment depends on the underlying cause.

Vocal cord paresis or paralysis

The vocal cords can become partially paralyzed (paresis) or completely paralyzed. The underlying cause is usually a viral infection that affects your vocal cord nerves or an injury to a nerve serving the cords during surgery, stroke, or cancer.

If the cords paralyze in a nearly closed position, your breathing may become labored and noisy. If they paralyze in an open position, your voice may become weak and breathy — a low-volume voice disorder. While some people get better over time, others experience permanent paralysis. Surgery and a course of voice therapy may help improve the quality of your voice.

Spasmodic dysphonia

This condition affects the vocal cords' nerves and causes them to spasm. Your voice may sound tight, quivery, or hoarse. Sometimes, your voice may sound normal, but at other times you may struggle to speak audibly or at all.

Treatment often includes speech therapy and injections of botulinum toxin (Botox®) to the vocal cords, which prevents nerve stimulation, thereby relaxing the muscles.

If you’re living with a low-volume voice disorder, it’s time to come into Oasis Ear, Nose, and Throat for an evaluation and treatment. Call the office at 623-207-7560.