Ta'lim innovatsiyasi va integratsiyasi
44-son_3-to’plam_May-2025
ISSN: 3030-3621
207
NEW ASPECTS OF DIAGNOSIS AND TREATMENT OF DYSPHONIA
Khaydarova Gavhar
Khalilova Madina
Abstract.
The article discusses the main aspects of diagnosis and treatment of
dysphonia at the present stage and provides modern clinical guidelines. There is a vast
array of pathological processes that can cause dysphonia. Of particular concern in this
context are neoplastic processes and neoplasms, as delays in their diagnosis lead to
higher mortality rates. If dysphonia persists for more than 4 weeks, laryngoscopy is
mandatory to rule out serious laryngeal diseases. People in voice-intensive professions
are most susceptible to dysphonia. It is important to identify risk factors in patients,
which include recent surgeries in the head, neck, and chest area, recent endotracheal
intubation, the presence of neck lesions, voice and speech professions, a history of
smoking, and signs of respiratory failure. Treatment for dysphonia depends on the
cause of the pathological process and may include management of the underlying
disease, pharmacotherapy, non-drug treatment, and surgical intervention. Among the
medications of allopathic medicine, there are very few drugs that specifically improve
the quality of voice function. In this regard, homeopathic medicines play a significant
role in the treatment of voice disorders, as they have demonstrated efficacy in clinical
studies and have a wide range of indications with minimal side effects. However, the
use of traditional homeopathic remedies is limited by the need for specialized
knowledge in homeopathy. To optimize the treatment of these patients, complex
homeopathic medicines have been developed, which can be used in combination with
conventional treatment by specialists without specific knowledge in homeopathy.
Keywords
: dysphonia, homeopathy, clinical homeopathy, hoarseness,
phoniatry, voice, laryngology
Introduction.
Dysphonia is a term that refers to a qualitative impairment of vocal function,
manifested by hoarseness, nasality, weakness, and rapid fatigue of the voice; patients
may also experience paresthesia and pain in the larynx, pharynx, and neck. Since the
same symptoms can occur in patients with a common cold as well as in those with
serious laryngeal pathology, all voice disorders should be evaluated by an
otolaryngologist or phoniatrist. Treatment of such patients should be carried out by a
specialist, taking into account the specific condition of the vocal apparatus in each
clinical case.
Prevalence of Dysphonia.
Ta'lim innovatsiyasi va integratsiyasi
44-son_3-to’plam_May-2025
ISSN: 3030-3621
208
According to the 2018 guidelines of the American Academy of Otolaryngology
– Head and Neck Surgery, dysphonia is a prevalent clinical condition affecting one-
third of the global population at some point in life. The guidelines define dysphonia as
a physician-diagnosed voice production disorder. While anyone can develop
dysphonia, individuals in voice-intensive professions and the elderly are particularly
susceptible [1,2]. The annual incidence of voice disorders among adults is
approximately 1 in 13. Unfortunately, there is a lack of comprehensive data on the
prevalence and treatment methods of voice disorders in domestic literature. The
increasing demand for vocal performance in various professions due to enhanced
communication requirements has led to a rise in voice-related pathologies [3-5]. For
example, over the past 50 years of the 20th century, the incidence of voice disorders
among teachers doubled [6,7]. A large cross-sectional study in 2001 reported a
dysphonia prevalence of 0.98% (536,943 dysphonia cases per 55 million people). The
condition was more common in women (1.2% compared to 0.7% in men) and
individuals over 70 years old (2.5% compared to 0.6–1.8% in other age groups) [8]. It
has been established that individuals in professions requiring significant vocal strain
are 1.4 times more likely to develop dysphonia than the general population [1]. Despite
the high prevalence of voice disorders, only a small proportion of patients seek medical
attention, yet economic losses due to disability can be significant.
Dysphonia is usually caused by benign or self-limiting conditions, but in some
cases, it can indicate a more serious condition requiring timely diagnosis [9-12].
Dysphonia significantly reduces the quality of life for patients, often leading to social
isolation, depression, anxiety, missed workdays, and lifestyle changes [1,13]. A meta-
analysis of studies has shown that non-neoplastic voice disorders have a comparable
impact on quality of life as conditions such as bronchial asthma, acute coronary
syndrome, depression, and chronic obstructive pulmonary disease [14].
Causes of Dysphonia.
There are many pathological processes that manifest as dysphonia. From a
diagnostic perspective, particular attention should be paid to dysphonia associated with
neoplastic processes in the head and neck region. In this group of patients, failure to
properly assess the larynx can lead to delayed diagnosis, resulting in the detection of
disease at later stages that require invasive treatment and have lower survival rates.
Other causes of voice disorders may include neurological conditions (vocal fold
paralysis, spasmodic dysphonia, essential tremor, Parkinson’s disease, amyotrophic
lateral sclerosis, multiple sclerosis), gastrointestinal disorders (GERD, eosinophilic
esophagitis), rheumatologic diseases (Sjogren’s syndrome, sarcoidosis, amyloidosis,
Wegener’s granulomatosis, rheumatoid arthritis), allergic conditions, pulmonary
diseases (e.g., COPD), musculoskeletal issues (muscle tension dysphonia,
fibromyalgia, cervicalgia), functional disorders, traumatic (including iatrogenic)
Ta'lim innovatsiyasi va integratsiyasi
44-son_3-to’plam_May-2025
ISSN: 3030-3621
209
factors, and infections [1,15]. Dysphonia may also be a side effect of various
medications such as anticholinergics, inhaled corticosteroids, decongestants, and
antihypertensives [1,2,13].
Diagnosis.
The importance of identifying the cause of dysphonia in patients presenting with
voice deterioration, pitch and volume changes, or hoarseness is unquestionable. Adults
can describe changes in their voice characteristics, while in young children, dysphonia
is identified by alterations in crying sounds. A thorough medical history should be
taken, including the onset and nature of dysphonia (sudden or gradual), potential
triggering events, the impact on quality of life, associated symptoms (swallowing
difficulties, respiratory distress), current medications, harmful habits (smoking,
alcohol consumption), comorbid conditions, and previous surgeries. Identifying risk
factors in such patients is critical. Risk factors include recent head, neck, or chest
surgeries, recent endotracheal intubation, the presence of a neck mass, a voice-
dependent profession, smoking history, and signs of respiratory failure [1].
During examination, the physician must assess voice quality and breathing
patterns. Dysphonia is an indication for laryngoscopy and visualization of the larynx,
as this symptom can be a sign of serious conditions where a delayed diagnosis is
unacceptable. A standard otolaryngological examination should be supplemented with
instrumental evaluations of the larynx, such as fiberoptic endoscopy, stroboscopy, and
other diagnostic methods as indicated. Laryngoscopy allows for the assessment of
laryngeal mucosa, vocal fold mobility and closure, and the involvement of vestibular
folds in phonation [1].
Treatment of Dysphonia.
The treatment of dysphonia depends on the underlying pathological process and
may include addressing the primary disease, pharmacotherapy, non-drug interventions,
and surgical treatment.
Non-Drug Treatments.
The main non-drug treatment methods for voice
disorders include phonotherapy and surgery. According to dysphonia treatment
guidelines, phonotherapy is effective for muscle tension dysphonia, Parkinson’s
disease-associated dysphonia, hypotonic dysphonia, presbyphonia, unilateral vocal
fold paralysis, vocal process granuloma, and may be used in combination with
pharmacological (e.g., botulinum toxin for spasmodic dysphonia) or surgical (e.g.,
post-medialization surgery) interventions. Surgical treatment is recommended for
patients with suspected malignancies, benign laryngeal tumors unresponsive to
conservative therapy, or hypotonic dysphonia. Functional microlaryngoscopic
procedures are commonly performed in such cases [1,15].
Pharmacotherapy.
For conservative treatment, antibiotics, anti-reflux
medications, and corticosteroids should not be prescribed without performing
Ta'lim innovatsiyasi va integratsiyasi
44-son_3-to’plam_May-2025
ISSN: 3030-3621
210
laryngoscopy, which is the prerogative of the otolaryngologist [1,13]. Depending on
the cause, pharmacotherapy may include systemic and topical corticosteroids,
antihistamines, mucolytics, systemic and topical antibiotics, among others. However,
many of these medications have side effects that limit their long-term use in routine
practice [1,13].
Homeopathy in Dysphonia Treatment.
Homeopathic preparations play an
important role in dysphonia treatment. Clinical studies have demonstrated their
efficacy, with a wide range of indications and minimal side effects [16]. However,
traditional homeopathic remedies require specialized knowledge. To optimize
treatment, complex homeopathic preparations have been developed that can be used in
combination with traditional treatments by specialists without expertise in
homeopathy. The only officially registered homeopathic medication for voice
disorders is Homeovox, produced by Boiron, France. It is indicated for laryngitis of
any etiology, hoarseness, and voice loss. Homeovox has anti-inflammatory and
mucolytic properties and improves voice quality from the first day of therapy,
accelerating recovery and restoring vocal function by day seven [17].
Conclusion
Thus, the use of complex homeopathic preparations for treating dysphonia of
various origins is effective and safe from an evidence-based medicine perspective.
Considering the above, Homeovox can be recommended for widespread clinical use,
particularly among professionals who rely on their voices.
References
1.
Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ et al.
Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol –
Head Neck Surg. 2018;
2.
Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness: Causes and treatments.
Dtsch Arztebl Int. 2015;
3.
Karpishchenko SA, Katinas EB, Kucherova LR, Ryabova MA, Ulupov MYu.
Photodynamic therapy for recurrent laryngeal papillomatosis. Golos i rech Voice
and Speech. 2010;
4.
Kunelskaya NL, Romanenko SG, Pavlikhin OG, Eliseev OV. Inhalation treatment
of inflammatory laryngeal diseases. Lechebnoe delo - Medical Business. 2011;
5.
Rubin JS, Wendler J, Wustrow V, Dejonckere PH, Wellens W, Kotby N. Phoniatric
provision and training: current European perspectives. J Laryngol Otol. 2007;
6.
Vasilenko Y.S. Voice. Phoniatric aspects. Moscow: Energoizdat; 2002;
7.
Lowell SY, Barkmeier-Kraemer JM, Holt JD, Story BH. Respiratory and laryngeal
function during spontaneous speaking in teachers with voice disorders. J Speech
Lang Hear Res. 2008;
Ta'lim innovatsiyasi va integratsiyasi
44-son_3-to’plam_May-2025
ISSN: 3030-3621
211
8.
Davids T, Klein A.M., Johns M.M. Current dysphonia trends in patients over the
age of 65: is vocal atrophy becoming more prevalent? Laryngoscope. 2012;
9.
Roy N, Merrill RM, Gray SD, Smith EM. Voice disorders in the general
population: prevalence, risk factors, and occupational impact. Laryngoscope.
2005;
10.
Titze I.R., Lemke J, Montequin D. Populations in the U.S. workforce who rely on
voice as a primary tool of trade: a preliminary report. J Voice. 1997;
11.
Coyle S.M., Weinrich B.D., Stemple J.C. Shifts in relative prevalence of laryngeal
pathology in a treatment-seeking population. J Voice. 2001;
12.
Roy N, Kim J, Courey M, Cohen S.M. Voice disorders in the elderly: A national
database study. Laryngoscope. 2016;
13.
Chang J, Bevans S.E., Schwartz S.R. Otolaryngology Clinic of North America:
Evidence-Based Practice. Management of Hoarseness/Dysphonia. Otolaryngol
Clin North Am. 2012;
14.
Cohen S.M., Dupont W.D., Courey M.S. Quality-of-life impact of non-neoplastic
voice disorders: a meta-analysis. Ann Otol Rhinol Laryngol. 2006;
15.
Feierabend R.H., Malik S.N. Hoarseness in adults. Am Fam Physician. 2009;
16.
Radtsig E.Y. Dysphonia: causes, methods for correction, and effects of different
groups of drugs on the voice quality. Farmatsiya - Pharmacy. 2014;
17.
Karneeva O.V., Ryazantsev S.V., Radtsig E.Y., Kim I.A. The possibilities of
clinical homeopathy in the treatment of acute inflammatory diseases of the upper
respiratory tract. Moscow, Saint Petersburg: Polimed Group, 2017;
