Volume Disturbance
Volume Disturbance may present as inability to speak or sing loudly or inability to phonate softly. Each voice has its own dynamic range. Professional voice users acquire greater loudness through increased vocal efficiency. They learn to speak and sing more softly through years of laborious practice that involves muscle control, and development of the ability to use the supraglottic resonators effectively. Most volume problems are secondary to intrinsic limitations of the voice or technical errors in voice production, although hormonal changes, aging and neurological disease are other causes. Superior laryngeal nerve paralysis will impair the ability to speak loudly. This is a frequently unrecognized consequence of herpes infection (such as “cold sores”) and may be precipitated by an upper respiratory tract infection.