Dysphonia, a disorder of vocal function, is a very important determinant of one's sense of functioning in society and, more specifically, of communicating with the world around one. Perceived disability due to this condition is associated with limitations in daily functioning and a significant decrease in quality of life. There are many factors that have a direct and indirect impact on vocal dysfunction, and one of the most significant is stress, which research shows has a significant impact on the development of dysphonia.
The voice is the basis of communication with the environment. It is an element of our lives that allows us to function in society and fulfil our life roles. The quality of our voice is the result of many factors, one of which - a very significant one - is stress. Poland is not an isolated country struggling with the problem of daily experienced stress, as almost 1/4 of our society declares this. In the context of our voice, all tensions resulting from experiencing stressful situations can lead to its disorders. These are known as dysphonia[1].
When approaching the classification of voice disorders, the associated difficulties are highlighted in the specialist literature. These arise from the functional-organic interconnection of laryngeal functioning, where organic changes resulting directly from the functional changes that occur within this organ are a common occurrence. Another problem that stands in the way of an adequate qualification of voice disorders is the heterogeneous causes - in other words, the variety of factors is very large. Phoniatrists (the branch of medicine dealing with pathologies occurring within the larynx and their treatment), when attempting to classify a diagnosed disorder, are required to take a very broad view of the pathological condition found in the context of a very large number of factors[2].
Referring to the classification of the Union of European Phoniatrists, voice disorders can be divided as follows: "normal voice; hoarseness; mild dysphonia; moderate dysphonia; aphonia; substitute voice (obtained with a prosthesis)"[2].
It is important to bear in mind that this is not the only classification of voice disorders and that they are constantly changing as knowledge of the mechanisms affecting voice disorders develops[2].
Dysphonia
The term dysphonia is a term for voice disorders that can manifest in many ways and under many forms. It refers to all the elements and qualities with which we can describe the functioning of our voice - as disorders can affect voice frequency, volume and timbre. The abnormalities referred to as dysphonia can manifest themselves in various combinations and occur in different "combinations". There are also cases where the abnormalities occur separately. Dysphonia is a change in the way the voice is emitted, the tone or character of the voice, its range, as well as its performance and function. Uncommon associated phenomena of dysphonia include hoarseness, which is the result of abnormal vibration of the vocal folds[2].
photo: panthermedia
Voice disorders may be caused by lesions of the larynx, as well as being the result of lesions located extraglottic. In addition, functional causes that result from abnormalities in phonatory processes can also be implicated. Malfunctioning muscles located both inside and outside the larynx cause disruptions, disharmony and abnormal respiratory-phonatory coordination.
Organic dysphonia refers to disorders that are caused by specific pathological changes - if treatment therapy is carried out correctly, they go into remission[2].
Stress and voice disorders
In the literature dealing with voice disorders, we find various studies on the perception of the causes of voice disorders by sufferers. In addition to upper respiratory tract infections, one of the most common causes is stress, perceived as having a significant impact on generating voice problems. However, experts are in no doubt that a single factor is not entirely responsible for the emergence of voice problems - rather, it is a question of overlapping co-existing factors[3].
Muscle tension in the head and neck due to the stress experienced significantly affects the breathing, which in turn becomes accelerated and becomes shallow, which can then lead to respiratory abnormalities. The emotional reaction itself can also have an impact on the emergence of tension in the larynx, and this becomes the cause of abnormalities associated with vocal fold vibrations. Considering the above-mentioned facts, stress is a very important factor influencing voice disorders. An additional aspect is the inhibition of the secretory glands, which can also take place in a stressful situation, and the result is experiencing dryness of the mucous membranes and discomfort in the mucous membranes, mouth, throat and larynx[1].
