Dysphonia (voice disorder)

Speech therapy
The speech therapist plays an important role in the assessment and treatment of patients with voice disorders, eg Reinke's oedema, vocal cord nodules and voice misuse. The therapy will take some weeks or months before any improvements are noticed and so the patient must be highly motivated.

Medical therapy
Upper respiratory tract infections, eg acute laryngitis, are commonly caused by viral infections. Bed rest, regular paracetamol and saline or soluble aspirin gargles are often adequate.

Antibiotics are only indicated when there is bacterial infection. Nasal sprays such as Beconase are used to treat patients who suffer from chronic inflammation of the sinuses and nasal lining and who get catarrh dripping down the back of the throat. Medications to reduce acid secretion by the stomach are used to treat patients with gastro-oesophageal reflux.

Surgery
Surgery is indicated for diagnosis (eg tissue biopsies) and treatment (eg removal of tumours and laser surgery). The operation is performed with a fibre-optic viewing 'telescope' (endoscope) under general anaesthesia.

The view of the larynx is magnified with a microscope so that delicate operations can be carried out. The procedure is known as 'microlaryngoscopy' or 'endolaryngeal microsurgery'.

Surgical management of non-cancerous causes of voice disorders is only indicated when all the other measures have failed.

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