VOCAL HYPERFUNCTION

Vocal hyperfunction or hyperkinetic use of the voice involves incorrect voice use. It can be a compensatory mechanism on an underlying weak voice.

WHAT IS VOCAL HYPERFUNCTION?

Vocal hyperfunction involves incorrect voice use and in many cases compensates for an underlying hypofunction. Patients complain of vocal fatigue, poor endurance and a painful voice (often burning pain). This is due to excessive use of the neck muscles to support the weakened vocal muscles. The person can often scream and has a mandatory falsetto. A falsetto is a voice with a high tone; think of an older man with a somewhat feminine sounding voice.

WHAT ARE THE CAUSES?​

  • Hypofunction or weak voice - In this case, hyperfunction is a compensatory mechanism of an underlying weak voice. People often force themselves to produce a strong voice. 'False vocal folds' are squeezed and they start to vibrate where the real vocal cords often do not close completely. This can be based on a neurological problem, such as partial vocal cord paralysis. This can cause a bending of the vocal cord muscle. This may indicate a lack of tension in the vocal chord, a lack of muscle mass or a lack of innervation of one of the muscles.

  • Incorrect use of voice after laryngitis - With a laryngitis or laryngitis, the vocal cords swell, making them less supple. As a result, the person often has to force extra hard to allow the vocal cords to vibrate. The false vocal folds are sometimes pressed closer together and start to vibrate and produce a very deep voice. When the cold is gone, the voice problem often seems to persist and the hoarseness remains, even though the swelling of the vocal cords is solved. This non-organic (learned) behavior is very easy and quick to correct and the normal voice can be completely restored. What is sometimes more difficult, the normal voice is maintained because the doctor or therapist can not solve all the stress and / or obligations in the patient's life, which are the cause of the problem.

WHAT ARE THE RISK FACTORS?

Persons with ​a weak voice or who recently had a laryngitis.

HOW ABOUT THE EXAMINATION?

The voice organ and its function are examined by an ENT doctor and a speech therapist. The voice has 3 functions: breathing, protecting the airway while swallowing and speaking. Every person is dependent on these 3 functions every moment of the day.

In addition to a thorough survey and a clinical examination of the neck, an inspection of the vocal cords (laryngoscopy) takes place at rest and during vocalization. This is supplemented by a stroboscopy, research in which through short flashes of light, the vibration pattern of the vocal cords is delayed and thus displayed in more detail.

Then, the voice and voice capacity is listened to. One can often hear the nature of the voice problem while speaking. Sliding, softer or louder voices, soft singing can help to find the right cause of the weak or painful voice.

In addition, a voice examination usually takes place, including aerodynamic parameters (the maximum phonation time), acoustically perceptual parameters (e.g. habitual speech pitch, voice quality in function of the change intensity and pitch) and the vocal range (intensity and frequency dynamics).

 
 
 
 
 

TREATMENT

Vocal hyperfunction can represent a long-term acquired behavior can be corrected through targeted therapy or vocal training. Therapy aimed at relaxing "hyperfunction" is rarely successful. Speech-building exercises or surgical filling of the vocal cords to add back mass to the vocal cords can be a solution.

If the underlying problem is stiffness, an operation aimed at softening the vibrating edge of the vocal cord may be necessary.