Specialty Service
Voice & Resonance Disorders
Restoring vocal health and clarity through targeted voice therapy. We treat voice disorders ranging from vocal nodules to muscle tension dysphonia.
Understanding the Condition
What are voice and resonance disorders?
Voice disorders occur when the quality, pitch, loudness, or flexibility of the voice is abnormal for a person's age, gender, and cultural background. They can result from structural changes to the vocal cords (such as nodules, polyps, or cysts), functional problems (such as muscle tension dysphonia), neurological conditions (such as vocal cord paralysis), or a combination of factors.
Vocal nodules are callous-like growths on the vocal cords caused by chronic vocal strain — often seen in teachers, singers, coaches, and others who use their voice heavily. Vocal cord dysfunction involves inappropriate closing of the vocal cords during breathing, causing episodes of breathing difficulty and voice changes. Muscle tension dysphonia is excessive tension in and around the larynx that disrupts normal voice production, often related to stress, compensatory patterns, or habitual vocal strain.
Resonance disorders affect how sound vibrates in the throat, mouth, and nasal cavities. Hypernasality (too much nasal resonance) and hyponasality (too little) are the most common types. Resonance disorders can be caused by structural issues (such as cleft palate), velopharyngeal dysfunction, or neurological conditions.
Voice therapy provided by a speech-language pathologist is the first-line treatment for most voice disorders. In many cases, behavioral voice therapy resolves the problem without surgery. When surgery is needed, voice therapy before and after the procedure optimizes outcomes.
Signs & Symptoms
What to look for
- Hoarse, raspy, or rough voice quality that persists for more than two weeks
- Voice that sounds breathy or weak, lacking normal projection
- Strained or effortful voice quality — feeling like you have to push to speak
- Loss of vocal range — difficulty reaching high or low pitches
- Voice fatigue — voice gets tired, weaker, or more hoarse with use throughout the day
- Frequent throat clearing or feeling of a lump in the throat
- Pain or tension in the throat, neck, or jaw when speaking
- Voice breaks or cuts out unexpectedly during conversation
- Pitch that is inappropriately high or low for your age and gender
- Hypernasality or hyponasality — too much or too little nasal resonance during speech
- Reduced vocal loudness — difficulty being heard in noisy environments
Our Approach
How we treat voice disorders
Vocal Function Exercises
A systematic exercise program that strengthens and balances the muscles of the larynx (voice box). These exercises improve vocal fold closure, endurance, and flexibility — similar to physical therapy for the voice.
Resonant Voice Therapy
Teaching a forward-focused, easy voice production technique that maximizes vocal output with minimal effort and strain. This approach is particularly effective for muscle tension dysphonia and vocal nodules.
Vocal Hygiene Education
Identifying and modifying the daily habits that contribute to voice problems — including hydration, caffeine and alcohol intake, vocal rest, reflux management, throat clearing habits, and environmental factors.
Behavioral Voice Therapy
Retraining patterns of voice use that cause or worsen voice disorders. This includes addressing speaking rate, loudness, pitch, breath support, and muscle tension patterns to promote healthy, sustainable voice production.
We recommend that anyone with voice changes lasting longer than two weeks see an ENT (otolaryngologist) for a laryngeal examination before beginning voice therapy. This allows us to understand the specific structural or functional cause of the voice disorder and design the most effective treatment plan. We work collaboratively with your ENT to coordinate care.
Who We Help
Primarily adults
Voice disorders are most common in adults, particularly those who use their voice professionally — teachers, singers, salespeople, attorneys, coaches, call center workers, and clergy. We also treat voice disorders caused by neurological conditions, surgery, intubation, and aging.
While less common, children can also develop voice disorders, often from chronic vocal strain (yelling, screaming) or structural causes. We provide voice therapy for children with vocal nodules, hoarseness, or other voice quality concerns.
If your voice is not working the way it used to — or the way you need it to — voice therapy can help. Most voice disorders respond well to behavioral treatment, and many patients see significant improvement within 6 to 8 sessions.
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Schedule a voice evaluation
Experiencing changes in your voice? Contact us to schedule an evaluation and start on the path to healthier, stronger vocal production.