20/6/2018 Voice Disorders: Incidence and Prevalence

Voice Disorders
Overview

Incidence and Prevalence

Voice disorders have been estimated to be present in between 3% and 9% of the U.S. population
(Ramig & Verdolini, 1998; Roy, Merrill, Gray, & Smith, 2005). However, information from a large U.S.
claims database (Cohen, Kim, Roy, Asche, & Courey, 2012) indicates the point prevalence (i.e., the
number of individuals with the condition in the database at the time that data were retrieved) of voice
disorders is 0.98% in a treatment-seeking population. This likely suggests that a large number of those
individuals with voice disorders do not seek treatment.

The prevalence of voice disorders among treatment-seeking individuals has been shown to be affected
by gender, age, and occupation (Cohen et al., 2012; Van Houtte, Van Lierde, D'Haeseleer, & Claeys,
2009).

Gender

Prevalence is higher in adult females than in adult males, with a reported ratio of 1.5:1.0 (Martins
et al., 2015; Roy et al., 2005).
In children, voice disorders are significantly more prevalent in males than in females (Carding,
Roulstone, Northstone, & the ALSPAC Study Team, 2006; Martins et al., 2015).

Age

Prevalence has been reported to be higher in elderly adults (Cohen et al., 2012; Roy, Stemple,
Merrill, & Thomas, 2007), with estimates ranging from 4.8% to 29.1% in population-based studies
(de Araújo Pernambuco, Espelt, Balata, & de Lima, 2014).
In the pediatric population, the reported prevalence of a voice disorder has ranged from 1.4% to
6.0% (Black, Vahratian, & Hoffman, 2015; Carding et al., 2006; Duff, Proctor, & Yairi, 2004).

Occupation

Occupational groups that appear to be most at risk for developing a voice disorder include
teachers, manufacturing/factory workers, salespersons, and singers (Cohen et al., 2012; Fritzell,
1996; Miller & Verdolini, 1995; Thibeault, Merrill, Roy, Gray & Smith, 2004; Williams, 2003).
The estimated prevalence of reporting a current voice problem was higher in teachers
(11.0%) than in nonteachers (6.2%; Roy et al., 2004).
Reported prevalence for teachers at a single point in time ranged from 9% to 37% (Cantor
Cutiva, Vogel, & Burdorf, 2013. Reported lifetime prevalence (i.e., the percentage of
teachers who experienced a voice disorder at some point in their lifetime) was between
50% and 80% (Cantor Cutiva et al., 2013; Martins et al., 2015).

Prevalence of Voice Disorder Etiologies

A wide range of etiologies may be associated with voice disorders. The relative proportion of these
etiologies is also affected by gender, age, and occupation (Cohen et al., 2012; Martins et al., 2015).

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20/6/2018 Voice Disorders: Incidence and Prevalence

Gender

Although adult females more frequently received diagnoses of dysphonia with no specific cause
noted, adult males were more frequently diagnosed with chronic laryngitis (Cohen et al., 2012).
Also, after the age of 40 years, males had higher prevalence rates of laryngeal cancer than did
females (Cohen et al., 2012).

Age

Among adults (aged between 19 and 60 years) with a voice disorder, the most frequent
diagnoses included functional dysphonia (20.5%), acid laryngitis (12.5%), and vocal polyps (12%;
Martins et al., 2015).
Of individuals over the age of 60 years who had been evaluated for vocal problems, voice
disorders were most commonly associated with presbyphonia (changes associated with aging
voice), reflux/inflammation, functional dysphonia, vocal fold paralysis/paresis, Reinke's edema, or
laryngeal cancer (Hagen & Lyons, 1996; Martins et al., 2015).
Vocal fold nodules were the most frequently diagnosed voice disorder in the pediatric population
(Martins, Hidalgo Ribeiro, Fernandes de Mello, Branco, & Tavares, 2012, Martins et al., 2015).
The prevalence of vocal fold nodules may be as high as 16.9% in school-age children and is
approximately twice as high for males than for females (Dobres, Lee, Stemple, Klummer, &
Kretschmer, 1990; Kiliҫ, Okur, Yildirim, & Güzelsoy, 2004).

Occupation

In a Flemish treatment-seeking population, the three main pathologies associated with

professional voice users (i.e., teachers, performers, telemarketers, broadcasters, salesmen, and
tour guides) included functional voice disorders (41%), vocal fold nodules/hypertrophy (15%), and
reflux/laryngitis/inflammation (11%; Van Houtte et al., 2009).

Signs and Symptoms

Causes

Roles and Responsibilities

Assessment

Treatment

Resources

References

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20/6/2018 Voice Disorders: Incidence and Prevalence

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