People develop voice problems for many reasons, from misusing their vocal cords to allergies to cancer. Mayo Clinic has voice specialists who can diagnose and treat any kind of voice disorder.

  • Team approach.The treatment team for voice disorders at Mayo Clinic is usually led by an ear, nose and throat (ENT) doctor experienced in voice problems. He or she consults as needed with other specialists to develop a treatment plan that's right for you.
  • Expert resources. Your treatment team also includes Ph.D.- and master's-level speech-language pathologists who specialize in evaluating and treating voice disorders.
  • Experience. Mayo Clinic specialists are experienced in treating all types of voice disorders. They have particular expertise in the microscopic removal of lesions on the vocal cords and in treating vocal cord paralysis.
  • State-of-the-art technology. Mayo Clinic uses the latest technology to accurately diagnose and treat voice disorders, including in-office potassium titanyl phosphate (KTP) laser treatment — a relatively new technology available at only a few places in the United States. KTP laser therapy can allow the removal of vocal cord lesions while preserving the maximum amount of underlying tissue.
  • Efficient care. At Mayo Clinic, your appointments are coordinated, so you usually can complete your testing and treatment within a few days.

Mayo Clinic in Rochester, Minn., ranks #1 for ear, nose and throat in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., is ranked among the Best Hospitals, and Mayo Clinic in Jacksonville, Fla., is ranked high performing for ear, nose and throat by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

Your voice box (larynx) is made of cartilage, muscle and mucous membranes located at the top of your windpipe (trachea) and the base of your tongue. Sound is created when your vocal cords vibrate. This vibration comes from air moving through the larynx, bringing your vocal cords closer together. Your vocal cords also help close your voice box when you swallow, preventing you from inhaling food or liquid.

If your vocal cords become inflamed, develop growths or become paralyzed, they can't work properly, and you may develop a voice disorder.

Some common voice disorders include:

  • Laryngitis
  • Neurological voice disorders (spasmodic dysphonia, pronounced spaz-MOD-ik dis-FO-ne-uh)
  • Polyps, nodules or cysts on the vocal cords (noncancerous lesions)
  • Precancerous and cancerous lesions
  • Recurrent respiratory papillomatosis (pap-ih-loe-muh-TOE-sis)
  • Vocal cord paralysis or weakness
  • White patches (leukoplakia, pronounced loo-ko-PLAY-key-uh)

Many factors can contribute to a voice disorder, including:

  • Aging
  • Allergies
  • Cancer
  • Drinking alcohol
  • Gastroesophageal reflux disease (GERD)
  • Illnesses, such as colds or upper respiratory infections
  • Improper throat clearing over a long time
  • Neurological disorders
  • Psychological stress
  • Scarring from neck surgery or from trauma to the front of the neck
  • Smoking
  • Throat dehydration
  • Thyroid problems
  • Voice misuse or overuse

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Arizona, otorhinolaryngology (ear, nose and throat) doctors have fellowship specialty training in voice disorders. Together with speech pathologists, they offer the full spectrum of treatment for voice disorders, including potassium titanyl phosphate (KTP) laser surgery.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Mayo Clinic in Florida offers a wide range of options for diagnosis and treatment of voice disorders. Treatment is provided by otorhinolaryngology (ear, nose and throat) doctors in who specialize in voice problems.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, speech pathologists and otorhinolaryngology (ear, nose and throat) doctors have fellowship specialty training in voice disorders. Together with speech pathologists, they offer the full spectrum of treatment for voice disorders, including potassium titanyl phosphate (KTP) laser surgery.

507-538-3270
7 a.m. to 6 p.m. Central time, Monday through Friday

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Your doctor will ask you detailed questions about your voice problems and examine you thoroughly. A topical anesthetic may be applied to numb your tissues before your doctor uses one of the following tools to examine your vocal cords:

  • Mirror exam. Similar to a dental mirror, a long, rigid instrument with an angled mirror inserted into your mouth.
  • Flexible laryngoscope. A flexible tube containing a light and camera, inserted through your nose.
  • Rigid laryngoscope. A rigid viewing tube, inserted through your mouth.
  • Videostroboscope. A camera combined with a flashing light to provide a slow-motion view of your vocal cords as they move.

Additional tests are sometimes used:

  • Acoustic (sound) analysis. Using computer analysis, your doctor can measure irregularities in the sound produced by the vocal cords.
  • Laryngeal electromyography. Small needles are inserted through the skin to measure the electric currents in your voice box muscles.

Depending on your diagnosis, Mayo Clinic doctors will recommend one or more treatments:

  • Rest, liquids and voice therapy. Like any other part of the body, the vocal cords need regular rest and fluids. Mayo Clinic speech pathology specialists can teach you how to use your voice more efficiently through voice therapy, how to properly clear your throat and how much liquid to drink.
  • Allergy treatments. If an allergy is creating too much mucus in your throat, Mayo Clinic allergists can identify the allergy's cause and provide treatment.
  • Smoking cessation. If your voice problem is the result of smoking, the Mayo Clinic Nicotine Dependence Center offers programs to help address tobacco use.
  • Medications. Several medications are available for treating voice disorders. Depending on the cause of your voice disorder, you may need medication to reduce inflammation, treat gastroesophageal reflux or prevent blood vessel regrowth. Medications can be taken orally, injected into the vocal cords or applied topically during surgery.

Procedures

  • Removal of lesions. Noncancerous lesions (polyps, nodules and cysts) on the vocal cords can form after months or years of voice misuse. Sometimes they occur in combination with respiratory infections. They may need to be surgically removed. Doctors at Mayo Clinic remove noncancerous, precancerous and cancerous lesions — including recurrent respiratory papillomatosis and white patches (leukoplakia) — using microsurgery, carbon-dioxide laser surgery, and when appropriate, the newest laser treatments such as potassium titanyl phosphate (KTP) laser treatment. KTP is a state-of-the-art therapy that treats lesions on the vocal cords by cutting off the blood supply to the lesion, allowing the lesion to be removed while preserving the maximum amount of underlying tissue. At Mayo Clinic, most of these surgeries are performed endoscopically through your mouth, so you won't have any external scarring.
  • Botox injections. Injections of tiny amounts of purified botulinum toxin into your neck skin can decrease muscle spasms or abnormal movements if you have a neurological movement disorder that affects the vocal muscles of the larynx (spasmodic dysphonia). Botox injections can relax muscles for up to five months.

Sometimes one vocal cord may stop moving (become paralyzed). If you have one paralyzed vocal cord, you might often complain of hoarseness. You might also complain of choking when you drink liquids, but rarely have trouble swallowing solid foods. Sometimes the problem goes away with time. If not, one of two procedures can be used to push the paralyzed vocal cord closer to the middle of the windpipe so that the vocal cords can meet and vibrate closer together. This improves the voice and allows the larynx to close when you swallow. Treatments include:

  • Fat or collagen injection. Body fat or synthetic collagen is injected, either through your mouth or the skin on your neck, to add bulk to the paralyzed vocal cord or to treat vocal cord weakness. The material fills the space next to your vocal cord and pushes it closer to your other vocal cord, allowing them to vibrate more closely together.
  • Thyroplasty. A small opening is created in the cartilage from the outside of your voice box. The doctor inserts an implant through the opening and pushes it against the paralyzed vocal cord, moving it closer to your other vocal cord.

See a list of publications by Mayo Clinic doctors on voice disorders on PubMed, a service of the National Library of Medicine.

Nov. 20, 2012