Phoniatric viewpoints on hoarseness

Abstract

Many things can be indicated by hoarseness, in the examination of which at least four different levels, not to be confused with each other, must be taken into account: (a) the psychological, (b) the acoustical, (c) the patho—physiological, (d) the patho—anatom—ical. A description of the above levels will be followed by a discussion of the mechanism of voice strain. A new theory is formulated, according to which vocal nodules develop chiefly as a result of excessive loading on the tenser ligaments in incorrect “open—voice” phonation.