Phoniatrics I pp 193-238 | Cite as

Basics of Voice Disorders

  • Sevtap Akbulut
  • Antoinette am Zehnhoff-Dinnesen
  • Felix de Jong
  • Matthias Echternach
  • Ulrich Eysholdt
  • Michael Fuchs
  • Tamás Hacki
  • Krzysztof Izdebski
  • Annerose Keilmann
  • Peter Kummer
  • Sanila Mahmood
  • Willy Mattheus
  • Dirk Mürbe
  • Tadeus Nawka
  • Haldun Oguz
  • Ekaterina Osipenko
  • Friedemann Pabst
  • Mette Pedersen
  • Rainer Schönweiler
  • Amélie Elisabeth Tillmanns
  • Erkki Vilkman
Part of the European Manual of Medicine book series (EUROMANUAL)


The chapter starts with the traditional definition of voice disorders based on main symptoms (hoarseness, limited laryngeal efficiency or vocal endurance, sensations of laryngeal discomfort) and systematic aetiological classification (organic-functional), whereas for ‘functional’, the alternative term ‘malregulative’ is recommended. Relevant parameters of voice production are presented in terms of a clinical and an acoustical setting as a basis for a plausible terminology. The long-lasting controversial discussion on vocal registers is objectified by associating subjective sensations and metaphorical interpretations with underlying mechanisms and typical physiological correlates. Another special view refers to the role of the external laryngeal muscles in voice production. Exact epidemiological data about specific types of voice disorders are still rare. Voice disorders are common in all age groups and in both sexes, with one third of the general population said to experience a voice problem once in their lifetime. The higher the voice load, the higher is the risk of developing a voice problem. An overview of pathology and pathogenesis of dysphonia focuses on malformations, inflammation, systemic diseases, malignancies and traumata affecting the larynx, resonance disorders and presbylaryngis. Current knowledge about the genetics of voice disorders is presented, covering vocal fold microstructure, vocal fold diseases, voice-related genetic syndromes and genetic neurological diseases. The genetic treatment approaches include tissue engineering, the use of technology tools and personalised medicine. A final section on the pathophysiology of voice production concentrates on manifestations such as hoarseness, roughness and breathiness, as well as on the influences of subglottal pressure, transglottal airflow and the supraglottal part of the vocal tract.


Voice production Dysphonia Definition Terminology Physiology Pathophysiology Vocal registers Epidemiology Aetiology Pathogenesis Genetics 

Supplementary material

Case Study Video 4.1

Breathy voice (MP4 11067 kb)

307062_1_En_4_MOESM2_ESM.mp3 (1.9 mb)
Case Study Audio Sample 4.1 Breathy voice (MP3 1895 kb) (103 kb)
Case Study Image 4.1 Voice range profile breathy voice (JPG 181 kb)
Case Study Video 4.2

Normal male voice (MP4 23600 kb)

307062_1_En_4_MOESM5_ESM.mp3 (1.8 mb)
Case Study Audio Sample 4.2 Normal male voice (MP3 1850 kb) (111 kb)
Case Study Image 4.2 Voice range profile normal male voice (JPG 187 kb)
Case Study Video 4.3

Normal female voice (MP4 16852 kb)

307062_1_En_4_MOESM8_ESM.mp3 (4.4 mb)
Case Study Audio Sample 4.3 Normal female voice (MP3 4490 kb) (102 kb)
Case Study Image 4.3 Voice range profile normal female voice (JPG 180 kb)
Case Study Video 4.4

Rough voice (MP4 29380 kb)

307062_1_En_4_MOESM11_ESM.mp3 (1.6 mb)
Case Study Audio Sample 4.4 Rough voice (MP3 1621 kb) (74 kb)
Case Study Image 4.4 Voice range profile rough voice (JPG 164 kb)
Case Study Video 4.5

Ventricular fold voice woman (MP4 16905 kb)

307062_1_En_4_MOESM14_ESM.mp3 (2.2 mb)
Case Study Audio Sample 4.5 Ventricular fold voice woman (MP3 2261 kb) (99 kb)
Case Study Image 4.5 Voice range profile ventricular fold voice woman (JPG 179 kb)
Case Study Video 4.6

Distortion of vocal fold vibration by adducting the ventricular folds (MP4 2605 kb)

307062_1_En_4_MOESM17_ESM.mp3 (1.9 mb)
Case Study Audio Sample 4.6 Vocal sound louis armstrong (MP3 1908 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • Sevtap Akbulut
    • 1
  • Antoinette am Zehnhoff-Dinnesen
    • 2
  • Felix de Jong
    • 3
  • Matthias Echternach
    • 4
  • Ulrich Eysholdt
    • 5
  • Michael Fuchs
    • 6
  • Tamás Hacki
    • 7
  • Krzysztof Izdebski
    • 8
  • Annerose Keilmann
    • 9
  • Peter Kummer
    • 10
  • Sanila Mahmood
    • 11
  • Willy Mattheus
    • 12
  • Dirk Mürbe
    • 12
  • Tadeus Nawka
    • 13
  • Haldun Oguz
    • 14
  • Ekaterina Osipenko
    • 15
  • Friedemann Pabst
    • 16
  • Mette Pedersen
    • 11
  • Rainer Schönweiler
    • 17
  • Amélie Elisabeth Tillmanns
    • 2
  • Erkki Vilkman
    • 18
  1. 1.Department of OtolaryngologyYeditepe UniversityIstanbulTurkey
  2. 2.Clinic of Phoniatrics and PedaudiologyUniversity Hospital MünsterMünsterGermany
  3. 3.Research Group ExpORL, University HospitalsLeuvenBelgium
  4. 4.Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric AudiologyMunich University Hospital (LMU)MunichGermany
  5. 5.Department of Medical Physics and Acoustics/Medical Physics and Cluster of Excellence Hearing4allCarl von Ossietzky-Universität OldenburgOldenburgGermany
  6. 6.Section of Phoniatrics and AudiologyUniversity of LeipzigLeipzigGermany
  7. 7.Department of Otorhinolaryngology, Head and Neck SurgerySemmelweis University BudapestBudapestHungary
  8. 8.Department of Otolaryngology, Head and Neck SurgeryDavid Geffen School of Medicine, UCLALos AngelesUSA
  9. 9.Voice Care Center Bad RappenauBad RappenauGermany
  10. 10.Phoniatrics and Pediatric AudiologyUniversity Hospital RegensburgRegensburgGermany
  11. 11.Voice UnitThe Medical CenterCopenhagenDenmark
  12. 12.Division of Phoniatrics and Audiology and Saxonian Cochlear Implant CenterUniversity Hospital Carl Gustav Carus, Technische Universität DresdenDresdenGermany
  13. 13.Department of Audiology and PhoniatricsCharité—University Medicine BerlinBerlinGermany
  14. 14.FonomerAnkaraTurkey
  15. 15.Phoniatrics DepartmentFederal Research Clinical Centre of OtorhinolaryngologyMoscowRussia
  16. 16.ENT DepartmentMunicipal Hospital DresdenDresdenGermany
  17. 17.Department of Phoniatrics and Pediatric AudiologyUniversity Clinic of Schleswig-Holstein, Campus LübeckLübeckGermany
  18. 18.Department of Otolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland

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