Immunologic Disorders
Voice disorders seem to occur in persons with immunologic disease, but without other obvious contributing etiologies (e.g., vocal abuse, laryngeal pathology). Although there is little research evidence about the potential effects of these immunologic disorders on laryngeal health and voice quality, clinicians who work in medical settings are familiar with the potential for voice change and deterioration in patients with: Rheumatoid arthritis, allergies, lupus, Sjogren’s disease, mixed connective tissue disease, and other autoimmune disorders. The changes in voice quality are not predictable, and certainly not every patient with these diagnoses will exhibit voice complaints. Most commonly, patients who are referred to a voice clinic with these disorders describe throat pain during talking, symptoms of vocal fatigue, loss of voice quality, endurance, or range. Certain infectious diseases, whether viral, bacterial, or fungal in origin, can also create or aggravate voice problems due to chronic laryngitis, and occasionally, granulomas. A large variety of infectious diseases provoke manifestations in the upper airway, including symptoms of chronic cough, irritation, edema, and eruptions of the mucous membranes of the larynx and pharynx. Examples include pneumonia, sinusitis, tuberculosis, and others. The associated dysphonia generally resolves following antibacterial treatment of the microorganism.