1. Why is my voice hoarse? What causes a voice to become
hoarse?
Voice hoarseness can be caused by the following:
■ Secondary to a viral or bacterial infection causing the laryngeal mucosa to swell
■ Acid reflux (laryngopharyngeal reflux)
■ Secondary to mass lesion/s on the vocal cords
■ Secondary to a complication after a neck surgery (e.g. thyroidectomy)
■ Secondary to cardiac or pulmonary conditions that might impinge the recurrent laryngeal nerve as it courses through the aorta and pulmonary artery to the larynx. This impingement might cause left sided vocal fold paralysis or paresis (weakness)

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2. Why does my voice shake when I talk? I feel that my voice
seems strangulated.
You may be suffering from spasmodic dysphonia, specifically adductor spasmodic dysphonia (ADSD). ADSD is characterized by uncontrollable spasms of the vocal fold muscles. These sudden, involuntary movements interfere with the proper vibration of the vocal folds.

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A shaky voice (sometimes described as a voice with tremors) can also be caused by muscle tension dystonia (MTD). This disorder causes the muscles around the larynx to tighten, causing it to work inefficiently. This results in a voice that sounds strangulated. Muscle tension dystonia is prevalent among 40-50-year old women

3. Why does my voice sound weak and breathy?

A weak or breathy voice may be caused by spasmodic dysphonia, specifically abductor spasmodic dysphonia (ABSD). This form of spasmodic dysphonia is less common, the spasm  causes your vocal folds to remain open, resulting in a weak and breathy voice. Some patients may describe this as a murmured or whispery voice.

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4. Why does my voice suddenly sound high/low-pitched?
This can also be caused by adductor spasmodic dysphonia, please refer to FAQ#1 for the possible causes.

5. Why does my voice cut out when I talk?
This can also be caused by adductor spasmodic dysphonia, please refer to FAQ#2 for the possible causes.

6. Why does my voice crack? Is it normal for a voice to crack even
for females?

A voice can crack due to the reasons enumerated in #1. This can also be caused by spasmodic dysphonia, please refer to #s 2 and 3.

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7. Is having a sore throat serious? Is it a symptom of COVID?
Yes, it is one of the common symptoms of COVID 19. But it doesn’t mean that if your throat is sore, you already have COVID.

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8. What kind of doctor treats spasmodic dysphonia?
If you feel that you may have spasmodic dysphonia, it is best to consult with an ENT-HNS doctor, specifically a laryngologist who is trained to assess/diagnose spasmodic dysphonia. Not all ENT-HNS specialists are aware of spasmodic dysphonia or trained to identify this condition. As a result, SD patients can be misdiagnosed if not seen by an ENT or laryngologist who have hands- on experience in correcting this condition.

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9. What should I expect when I visit a voice doctor for spasmodic
dysphonia?

You would expect a thorough history-taking and physical examination by the laryngologist. Additional procedures such as videostroboscopy will be performed for anatomical assessment. Videostroboscopy is a technique wherein the doctor gently inserts a thin flexible tube attached to a video camera through the nose and into the back of the patient’s mouth to visualize your vocal cords.

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10. How is SD diagnosed? What are the possible treatments?

SD is diagnosed by a trained ear. It should be taken into consideration that not all ENT-HNS are exposed to this condition since cases are limited or at least overlooked, hence there is a large margin that is misdiagnosed. There are some videostroboscopic findings which suggest SD that can lead to a high index of suspicion for the diagnosis.

11. What are the possible treatments of spasmodic dysphonia?
Currently, these are the available treatments for spasmodic dysphonia in the Philippines:

■ Temporary – Botox (ADSD)
■ Permanent – Type 2 thyroplasty (ADSD) or lateralization
■ For ABSD (difficult to treat, we might do further
assessment)

 

Botox and thyroplasty to help manage spasmodic dysphonia are offered at IMVC Manila​

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12. How much does surgery for spasmodic dysphonia in the
Philippines cost?
Cost of spasmodic dysphonia thyroplasty at IMVC Manila varies due to a number of factors. Please call 0917 637 5588 for further information or you can fill up our form.

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13. I am a transgender, can a doctor make my voice sound more
female/male?

Technically yes, we just have to assess your voice first (voice analysis) to know if the said range that you are aiming for is feasible.
 

14. What is the procedure for a voice change? Is this available in the
Philippines?

Voice change procedure from female to male is known as Type 3 thyroplasty. Voice change procedure from male to female is Type 4 thyroplasty. Both voice change procedures can be performed at IMVC Manila.

15. How much does voice feminization/ voice masculinization cost in
the Philippines?

Cost of voice feminization or voice masculinization in the Philippines varies due to a number of factors. Please call 0917 637 5588 for further information or you can fill up our form.

16. My voice became permanently hoarse after my thyroidectomy.
Can you fix it?
Yes. There is a big possibility that your laryngeal nerve was severed during the procedure. This caused your true vocal cords to be paralyzed. This can be corrected with medialization or Thyroplasty type