Vocal underdoer syndrome

Vocal underdoer syndrome is a term coined by Dr. Anat Keidar and Dr. Robert Bastian to designate an individual whose amount and manner of voice use can be considered inadequate to keep the mechanism in good condition. Typically, the vocal underdoer syndrome comprises two parts: innate introversion/taciturnity and a life circumstance that permits, invites, or […]

Vocal Tremor

Vocal tremor: A regular, wavering quality of voice, analogous to a singer’s vibrato but occurring, to an individual’s distress, during speaking, not just during singing. May occur as a sole abnormality in essential voice tremor, or in combination with spasmodic dysphonia. Teaching demonstration (mimicked): Patient example dystonic tremor: Note accompanying squeezedowns and difference in two […]

Vocal Polyp

A large swelling on the vocal cord that typically occurs unilaterally—that is, without a similar swelling on the opposite cord. The term vocal polyp is somewhat imprecise, but vocal polyps can be distinguished from a similar kind of swelling, vocal nodules, in at least two ways: 1) polyps tend to be larger than nodules; 2) […]

Vocal Nodules

Small chronic swellings that appear in the junction of the middle and anterior thirds of the vocal fold. These swellings, or nodules (nodes), are vibratory injuries caused by vocal overuse. The most obvious symptom of medium-to-large nodules tends to be hoarseness. The top symptoms for nodules of any size may include: 1) difficulty with high, soft […]

Vocal fry

The name given to a quality of sound produced at low pitch. Vocal fry is produced in what some call pulse register, as compared with chest and falsetto registers.


In the voice, a pulsating effect produced by small variations of pitch, typically occurring five or six times per second. The opposite of singing with vibrato is to sing with straight tone.

Tonic Variant Spasmodic Dysphonia

A variant of spasmodic dysphonia (SD) in which the spasms (and their effect on the voice) are sustained rather than intermittent. Tonic variant spasmodic dysphonia is to be distinguished from classic variant SD. Individuals with a tonic variant of adductor SD have a sustained strained-sounding voice. Individuals with a tonic variant of abductor SD have a […]

Squeezedown (of the voice)

A vocal phenomenology term coined to refer to adductory spasms that do not “complete” all the way to a phonatory arrest. Virtually exclusively a manifestation of spasmodic dysphonia.

Smoker’s Polyps

Diffuse swelling of the vocal cords, due to build-up of edema fluid within the mucosa. Smoker’s polyps are also referred to as Reinke’s edema or polypoid degeneration. Audio with photos: Voice sample of a patient with smoker’s polyps, BEFORE surgery (see this patient’s photos just below): Same patient, two months AFTER surgery (the occasional syllable dropouts […]

Respiratory Dystonia

A syndrome caused by laryngeal dystonia in which the larynx’s breathing function is affected. Laryngeal dystonia much more commonly affects the voice (spasmodic dysphonia) rather than breathing, but occasionally it affects only breathing, or both breathing and voice. Individuals afflicted with respiratory dystonia may have difficulty inhaling air through a glottis closed by adductory spasms, […]