Voice and Swallowing Disorders
Voice and swallowing disorders are very important conditions to recognise, evaluate and treat in a timely manner.
Phonation is the medical term for the production of the voice by the larynx (voicebox). Dysphonia is the medical term for disordered voicing or an abnormal voice. Most people describe their voice change using terms such as hoarseness, huskiness or raspiness.
Dysphonia is important because of the significant impact it has on a person’s quality of life, their ability to interact with others, their ability to work, and because it may be the first sign of a serious underlying medical condition, such as a cancer of the throat, or even a chest problem.
Dysphonia is a common symptom in the general population and its prevalence does vary according to the vocal demands of each person. People who use their voice a great deal more than average for their occupation -such as teachers, singers, musicians, actors, the clergy, lawyers, doctors, salespeople and customer service representatives - are at increased risk of developing a voice disorder. Teachers are the occupational group most often diagnosed with a voice disorder. The prevalence of voice disorders in the general population is 6% in non-teachers, but 11% in teachers. The prevalence of a voice disorder occurring at any time in a person’s lifetime is approximately 30% for non-teachers and 60% for teachers.
Swallowing is the process by which food and fluid is transported from the mouth to the stomach. Swallowing is a complex activity that is divided into three stages: the oral (mouth), pharyngeal (throat) and oesophageal phases.
Dysphagia is the medical term for difficulty swallowing, and includes aspiration, which defined as the unwanted passage of swallowed material into the lower airway, inferior to the vocal folds. Aspiration is a serious problem, because aspiration may result in life threatening respiratory complications, such as laryngospasm, bronchospasm, tracheobronchitis and pneumonia.
Dysphagia is a very important symptom to recognise because it raises significant issues for the person who has the difficulty swallowing: nutrition and hydration, safety (aspiration may lead to respiratory complications such as pneumonia), psychological wellbeing, and the possibility of cancer.
A multidisciplinary team approach for the evaluation and treatment of people with a swallowing disorder is recommended, as there are many possible causes and several complementary approaches to treatment. The team may include clinicians from Otorhinolaryngology, Speech Language Therapy, Radiology, Nutrition, Neurology, Gastroenterology, General Surgery, Physiotherapy and Rehabilitation Medicine.