Hoarseness of Voice: Pathophysiology

Introduction

Hoarseness of voice, medically termed dysphonia, refers to abnormal vocal quality characterized by roughness, breathiness, or altered pitch. It stems from functional or structural changes in the larynx affecting phonation.

Pathophysiology

Mechanism of Voice Production

The human voice is generated by vibration of the vocal folds within the larynx. This process is modulated by air pressure from the lungs, intrinsic laryngeal muscle tension, and resonance in the vocal tract.

Causes of Hoarseness

• Inflammatory Changes: Laryngitis due to infections, allergies, or irritants disrupts normal vocal fold function.
• Neuromuscular Dysfunction: Conditions like vocal cord paralysis or spasmodic dysphonia lead to dysregulated phonation.
• Structural Abnormalities: Nodules, polyps, or tumors alter the vibratory capacity of vocal folds.
• Endocrine Influence: Hormonal disorders, such as hypothyroidism, affect vocal fold elasticity and tension.

Clinical Implications

Hoarseness may be transient or indicate underlying pathology requiring medical attention. Persistent hoarseness necessitates otolaryngologic evaluation with laryngoscopy and voice analysis.

Conclusion

Understanding the pathophysiology of hoarseness aids in diagnosis, treatment, and vocal rehabilitation. Management strategies depend on etiology and range from vocal hygiene to surgical intervention.