The human voice serves as our innate instrument, enabling us to articulate speech for self-expression. It stands as the foremost and primary mode of communication. The voice emerges from the intricate integration and coordination of numerous structural and physiological systems (1). It reflects the internal and external status of the individual, such as long-term and short-term physical status, emotional status, and psychological status (2). In addition, the voice is an important tool for social communication and is also strongly related to one’s professional/vocational and/or educational status, it is influenced by cultural context and social expectations (3). A good voice can be defined as one with a habitual pitch level that is suitable for the age, sex, and size of the individual sufficient loudness appropriate inflection involving pitch and loudness a pleasing quality, and the proper balance of oral and nasal resonance (4).
Several studies indicated that voice disorders have an influence on participants' life such as a limitation on social activities due to some psychological problems. Also, some physical discomfort due to voice disorders was reported (1). The persons who depend on their voices for their occupation “professional voice user “are the most vulnerable to voice disorders (1, 2, 4). Human voice users are at risk of developing occupational voice disorders, the pathogenesis of their voice disorders is mainly related to their occupation and will most likely require prevention and treatment (5).
Voice disorder is a difficulty with generating voice that is mainly caused by a disruption or loss of normal laryngeal function and is defined by abnormal vocal features and elements such as pitch, and loudness as a result of disrupted laryngeal, respiratory, and/or vocal tract functioning (5).Voice disorders happen when vocal health (VH) is affected (6). Voice disorders are known to be a serious occupational threat (3), and numerous risk factors contribute to voice disorder, such as personal factors including gender, family history of vocal problems, allergies, vocal load, work-related stress, and others, can also contribute to voice disorders (4).
Dejonckere has reported some risk factors that could increase the probability of having voice disorders. They began with voice use patterns like talking loudly, throat cleaning, and laughing. In addition, some specific acute respiratory conditions such as upper respiratory system viral and bacterial inflammations could also increase the risk factor of having voice disorders. Family history also may play a role in having a voice disorder. At the same time, the risk factor of having a voice disorder increases with the increase in chemical exposures. On the other hand, they reported that some abusive behaviors like tobacco smoking, and alcohol do have a serious effect on the voice (3, 5).
A voice disorder is referred to as "functional" when the abuse or misuse of the physically and physiologically intact vocal apparatus is the major cause of a voice problem. The cause may be unclear or obvious, but repeated vocal cord misuse can result in nodules, polyps, ulcers, or granulomas later (7). Voice disorders are referred to as organic if physiological voice disorders are affected by changes in one or more of these mechanisms: the respiratory, laryngeal, or vocal tracts. Organic disorders include structural and neurogenic voice disorders. Structural voice disorders are caused by physical abnormalities in the voice system and are known as organic voice disorders such as edema, vocal nodules, and changes in the larynx as a result of aging. While neurogenic voice disorders are caused by problems in the central or peripheral nervous system which innervate the larynx such as vocal tremors, spasmodic dysphonia, or partial or complete paralysis of vocal cords (2, 6–9).
For better production and maintenance of functional human voice, particular home care strategies may help to relieve some symptoms that must be coupled together for a better result. Beginning first with a vocal hygiene program represented by the speech-language pathologist (SLP) that helps in increasing the awareness of avoiding the misuse and overuse of the voice, as well as vocal instruction provided by the SLP to maintain good production of voice (10). In addition, a precise assessment of the impact of organic disease and accompanying medical treatment on voice function is crucial for effective treatment planning. Another home care strategy is natural therapies. Although these natural therapies haven't been studied scientifically for their effects on voice in general and on voice disorder symptoms in specific, professionals of alternative medicine often recommend them to decrease these symptoms (11).
The developing and increasing diversity of pharmaceuticals that were built for this purpose has led to a rise in the pharmacological possibilities for the treatment of voice disorders. Where the symptoms of voice disorders arise as a part of physiological processes or disease, herbal remedies may improve voicing characteristics (12). Dysphonia is characterized by an abnormal voice and is sometimes referred to as hoarseness. There are several reasons for dysphonia and voice changes may develop abruptly or gradually over time. Gravely, breathy, weak, strained, raspy, rough, or hoarse, describe the dysphonia condition (13).
Plants have been utilized for the treatment of voice disorders since prehistoric days, and numerous medicinal plants are currently in use in all cultures for this purpose. The mechanisms of action of these plants include mucolytic, anti-inflammatory, antibacterial, and other general activities; however, mechanisms that could specifically refer to voice are frequently unknown, as are the corresponding molecular targets, making a rational approach in the use of these remedies difficult for phoniatricians to apply. Ethnopharmacological studies provide access to precious indigenous knowledge woven into the fabric of traditional medicine. This study technique serves as a crucial lens through which we investigate the cultural importance of herbal treatments as well as their potential for treating voice issues. Utilizing ethnopharmacological studies can give insight regarding the utilization of medicinal plants for diseases and disorders, in addition to capturing the empirical knowledge inherent in traditional therapeutic practices.
By filling an important gap in the existing body of knowledge, this research specifically investigates the scarcity of data concerning the utilization of botanicals for voice disorders. The necessity to increase our knowledge of traditional medicinal practices pertaining to voice care motivates the investigation. Therefore, the current study aims to collect data from herbal medicine practitioners in the West Bank area of Palestine on herbal remedies used to treat voice disorders.