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  • Dr. Wohlt
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    • Press & Media
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    • Appointments
    • Berlin Center
    • Vienna Center
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  • Voice Disorders
    • Voice Disorders – General Information
    • Vocal Cord Paralysis
    • Vocal Cord Nodules
    • Vocal Cord Polyps
    • Reinke’s Edema
    • Vocal Cord Cyst
    • Laryngeal Papillomatosis
    • Vocal Cord Granuloma – Contact Granuloma
    • Vocal Cord Leukoplakia | Laryngeal Cancer
    • Aging Voice – Vocal Cord Atrophy
    • Functional Dysphonia
    • Psychogenic Dysphonia
  • Voice Surgery
    • Voice Surgery – General Information
    • Vocal Cord Paralysis Surgery
    • Vocal Cord Nodules Surgery
    • Vocal Cord Polyp Surgery
    • Reinke’s Edema Surgery
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    • Laryngeal Papillomatosis Surgery
    • Vocal Cord Leukoplakia Surgery
    • Vocal Fold Augmentation After Cancer Surgery
    • Anti-Aging Voice Surgery
  • Voice Therapy
    • Voice Therapy – Speaking Voice
    • Voice Therapy – Singing Voice
    • Vocal Rehabilitation After Vocal Cord Surgery
  • Singers’ Page
    • Vocal Arts Medicine
    • Voice Surgery for Professional Singers
    • Vocal Rehabilitation for Professional Singers
    • Vocal Cord Surgery for Singers

Functional Dysphonia

What does the term “functional dysphonia” mean?

Voice disorders are classified as functional dysphonias when the voice quality is impaired by hoarseness and laryngeal performance is limited without the voice-producing structures being affected by any morphological-pathological changes. Frequently, patients describe subjectively abnormal sensations or paresthesias around the larynx.

Functional dysphonia can be manifest in two main forms, which are either characterized by “too much” or a "too little” muscular tension.

The form associated with excessive muscular tension is called hyperfunctional dysphonia; the form associated with diminished muscular tension is termed hypofunctional dysphonia.

Hereby, it is important to note that the two clinical pictures are rarely observed in their pure form. Usually, mixed forms are encountered with transitions between one state of muscular activity and the other.

How does functional dysphonia develop?

Etiologically, the causes are assumed to be multifactorial, especially given the complexity which interweaves the vocal phenomena and the anatomical structures required to produce voice. Multiple factors — including constitutional, habitual, psychogenic and occupational causes — can affect voice quality in a number of significant ways.

An exclusively voice-focused diagnosis cannot do justice to these multiple interconnections.

What symptoms are caused by functional dysphonia?

Hyperfunctional Dysphonia

The cardinal symptom of this form of functional dysphonia is a more or less severe roughness of the voice. The patient talks with a hard, pressed voice that is abnormally placed towards the back of the throat.

Over the medium term, the hyperfunctional vocal pressure patterns trigger organic stress reactions that manifest on the vocal folds, e.g. vocal cord nodules.

Hypofunctional Dysphonia

This voice disorder is mainly characterized by breathy, low-pitched and quiet phonation. In hypofunctional dysphonia, the voice placement tends to show a more dorsal shift. Overall voice performance is limited and echoed by the debilitated and low-energy communication ability commonly found in these patients. Not without reason, this pathological constellation, now termed hypofunctional dysphonia, was formerly called phonasthenia: i.e., weakness of voice or difficult phonation.

What is the treatment for functional dysphonia?

The therapy of choice for functional dysphonia is voice therapy. A variety of voice therapeutic approaches and methods try to treat dysfunctional voice production by considering the triggers for the conditions.

Here, it is important to note that functional dysphonias are frequently based on multifactorial pathological processes, and successful treatment can only be expected when the therapeutic interventions manage to take this multidimensionality into account.

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Gerrit Wohlt, M.D.
Board-certified Laryngologist
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10719 Berlin

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Gerrit Wohlt, M.D.
Board-certified Laryngologist
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Phone +43 1 513 05 27
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© Dr. med Gerrit Wohlt 2023

The medical content of this website is intended for educational purposes only and should not be construed as medical advice or used in place of consulting a qualified medical professional. Specific details may not apply to the individual case and under no circumstances should treatment decisions be based thereupon. Great care was taken in compiling the most accurate information for this website. Notwithstanding these efforts, medicine is a dynamic and living science undergoing constant flux. All warranties, express or implied, with respect to the accuracy, completeness, timeliness or quality of the details provided are therefore disclaimed. The user of this website is hereby made aware of these limitations.

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Gerrit Wohlt, M.D.
Board-certified Laryngologist
Board-certified Phoniatrician

Fasanenstraße 70
10719 Berlin

Phone +49 30 315 076 55
Mail info@wohlt.de

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Gerrit Wohlt, M.D.
Board-certified Laryngologist
Board-certified Phoniatrician (Voice and Speech Medicine)

Fichtegasse 2A
1010 Wien

Phone +43 1 513 05 27
Mail info@wohlt.at

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The medical content of this website is intended for educational purposes only and should not be construed as medical advice or used in place of consulting a qualified medical professional. Specific details may not apply to the individual case and under no circumstances should treatment decisions be based thereupon. Great care was taken in compiling the most accurate information for this website. Notwithstanding these efforts, medicine is a dynamic and living science undergoing constant flux. All warranties, express or implied, with respect to the accuracy, completeness, timeliness or quality of the details provided are therefore disclaimed. The user of this website is hereby made aware of these limitations.

© Dr. med Gerrit Wohlt 2023