The larynx is affected by more than direct injury or surface growths. Hormones can remodel the vocal cords, just as they do during puberty. Proteins can be deposited along the vibrating edge, stiffening and thickening it over decades. Joints that control vocal cord stretch can seize with arthritis. And foreign material can become trapped in the laryngeal ventricle, slowly calcifying and swelling until the voice fails entirely. These cases illustrate how disorders far from the vocal cord surface can profoundly alter the voice.
◆ Using Testosterone
Lee B. Doe was nearing 50 and using testosterone cream for energy. Her upper singing range had narrowed to a crack at D5 — and was not coming back. Testosterone in females produces the same vocal changes as male puberty, thickening and stiffening the cords gradually and irreversibly.
◆ Amyloidosis
Christina Amarillo had been getting progressively more hoarse for 10 years — and her mother and three aunts were all hoarse too. Yellow amyloid deposits along the edges of her vocal cords stiffened them and prevented complete closure. The deposits return, but they can be surgically removed again.
◆ Arthritis of the Laryngeal Joints
John Davenport, a trained singer turned pastor, had lost his upper range to arthritis of the cricothyroid joint. His vocal cords would not change length on command — the frozen joint prevented the CT muscle from doing its job.
◆ Foreign Body: Trapped
Julie Trappe had been hoarse for years from what seemed like an unusually located mucocoele — until a CAT scan revealed the center was calcified. At surgery, a stone had grown around a trapped food particle in the laryngeal ventricle over many years.