Neurological Voice Disorders: A Review

ABSTRACT

Aim

To provide an overview of neurological disorders affecting the larynx, either primarily or as part of a systemic disease process. In this review, we first present an overview of the approach to diagnosis and treatment of neurological diseases of the larynx, and then move on to discuss individual conditions in more detail.

Background

Neurolaryngology focuses on the neuromuscular function of the larynx. Laryngeal issues such as cough, aspiration, and hoarseness are among the most common problems in ambulatory medicine and aspiration is the leading cause of morbidity and mortality in the geriatric population and is especially prevalent in neurodegenerative disease.

Review results

Neurological voice disorders can be divided into three categories: those that originate from the central nervous system, those that originate from the peripheral nervous system, and those that are functional or behavioral in nature. Several central nervous system disorders have manifestations in the larynx—the disorders most commonly seen by otolaryngologists are: dystonia, essential tremor, Parkinson's disease, and stroke. Laryngeal disorders originating from the peripheral nervous system include vocal fold paresis/paralysis and myasthenia gravis. Functional voice disorders include muscle tension dysphonia and paradoxical vocal fold motion.

Conclusion

Neurological voice disorders can originate the from the central or peripheral nervous system, or be functional in nature. It is important for the otolaryngologist to be able to be familiar with history and physical examination findings that suggest neurological pathology, and also be able to recognize specific findings pertinent to each individual condition.

Clinical significance

Patients with central nervous system disorders can often have laryngeal complaints as their first presenting symptom. Therefore, the otolaryngologist can sometimes be the first physician to diagnose such conditions, and plays an important role in coordinating and providing therapies that significantly improve quality of life for these patients. Current research involving machine learning and functional neuroimaging may greatly improve the diagnosis of many of these disorders in the near future.

How to cite this article

Wang TV, Song PC. Neurological Voice Disorders: A Review. Int J Head Neck Surg 2022;13(1):32-40.