Vocal Fold Phonotrauma

Vocal Fold Phonotrauma

Anatomy of the Condition

Vocal fold misuse and abuse can cause a variety of problems beyond hoarseness. In cases of muscle tension dysphonia (hoarse voice), excessive tension in and around the muscles of the larynx leads to an abnormal voice. Prolonged phonotrauma can cause swelling of the vocal folds or development of vocal fold nodules, vocal fold polyps or vocal fold cysts (benign masses of the larynx). Screaming or other extreme vocal activity may even cause a hemorrhage of the vocal folds.

Causes of Vocal Fold Phonotrauma

Contributing factors that can result in hoarseness and related conditions include:

  • 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
  • Poor diet or health
  • Hearing loss


Symptoms that may indicate you suffer from vocal fold misuse or vocal fold abuse include:

  • 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


Our team will discuss your symptoms and medical history. We will perform a thorough head and neck examination. Our evaluation team often involves several members of the Emory Voice Center. We will assess vocal quality, efficiency, and proper speaking technique.

We may complete a laryngeal videostroboscopy. In this minimally invasive procedure, we use an endoscope (a small tube equipped with a fiber optic camera). A stroboscopic light source lets us check laryngeal function and vibration.


Voice misuse syndromes occur often. We can almost always treat them with voice therapy and without operating.


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