"I can come by here and have a couple of polyps lasered off my vocal cords and then go straight to work."
— Daryl Collins, age 53

More Testimonials

Voice Misuse and Voice Abuse

Anatomy of the Condition:

Voice misuse and abuse can cause a variety of problems. Muscle tension dysphonia is a condition where excessive tension in and around the muscles of the larynx leads to an abnormal voice. Prolonged voice misuse can cause swelling of the vocal folds or development of nodules, polyps or cysts (benign masses of the larynx). Screaming or other extreme vocal activity may even cause a hemorrhage of the vocal folds.

Causes or Contributing Factors:

  • Excessive talking without resting the voice
  • Straining or unnatural use of the voice for long periods
  • Screaming
  • Loud talking in noisy environments
  • An abnormally low or high speaking voice pitch
  • Poor breath support in speaking and singing
  • Use of excessive tension in the muscles of, in and around the larynx
  • Poor posture in speaking and singing may be a contributing factor
  • Poor diet or health can be a contributing factor
  • Hearing loss can be a contributing factor


  • Hoarseness
  • Rough or scratchy voice
  • Vocal fatigue
  • Increased vocal effort
  • Throat tenderness or soreness
  • Loss of upper range in singing
  • Difficulties with vocal register changes in singing


The physician will ask the patient about symptoms and medical history, followed by a thorough head and neck examination. Examinations generally involve several members of The Emory Voice Center team to test for vocal quality, efficiency, and proper speaking technique.

Laryngeal videostroboscopy may be required. This is a procedure using a flexible and/or rigid endoscope coupled to a video monitor and a stroboscopic light source to allow for detailed visual evaluation of laryngeal function and vibration.


Voice misuse syndromes are fairly common and can almost always be treated non-operatively with voice therapy.