This clinic-based cross-sectional study described the occupational and clinical characteristics of teachers presenting with voice disorders at a specialized otolaryngology clinic in Georgia. The findings demonstrated that inflammatory laryngeal conditions and benign vocal fold lesions were common among treatment-seeking teachers. At the same time, hoarseness and variable voice quality represented the most frequently reported voice-related symptoms. Participants with benign vocal fold lesions had higher perceived voice handicap scores than teachers with inflammatory laryngeal conditions.

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Teachers are widely recognized as a high-risk occupational group for voice disorders because of prolonged voice use and continuous occupational vocal demands. The predominance of inflammatory laryngeal conditions observed in this study likely reflects the clinic-based nature of the study population. Teachers frequently seek specialist evaluation during episodes of acute dysphonia, whereas chronic structural lesions may develop gradually before referral. Therefore, the diagnostic distribution reported here should not be interpreted as the prevalence of voice disorders among teachers in the general population. The findings of the present study are generally consistent with international literature reporting a high burden of voice disorders among teachers and other professional voice users. 1,2 Similar studies conducted in different educational settings have identified hoarseness, vocal fatigue, and voice instability as common complaints among teachers exposed to intensive vocal load and unfavorable workplace conditions. 3,4

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Several occupational factors potentially associated with increased vocal strain were identified in the present study. Many participants reported noisy classroom environments and work-related stress during teaching activities. These occupational conditions may contribute to excessive vocal effort, particularly when teachers are required to increase vocal intensity for prolonged periods in order to maintain classroom communication. Previous studies have similarly demonstrated that classroom noise, prolonged speaking duration, and increased vocal intensity are important occupational contributors to voice disorders among teachers. 4,5

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Lifestyle and health-related factors potentially influencing vocal health were also frequently reported among participants. Smoking, chronic cough, gastroesophageal reflux disease, allergic conditions, and thyroid disorders were observed in a substantial proportion of teachers. These conditions may contribute to laryngeal irritation and vocal symptoms through chronic inflammation, throat clearing, mucosal irritation, or altered vocal fold function. Previous studies have similarly reported associations between reflux disease, respiratory conditions, smoking, and increased risk of voice-related symptoms among professional voice users. 3,4

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Videostroboscopic assessment demonstrated that inflammatory laryngeal conditions and benign vocal fold lesions were among the most frequent findings in teachers presenting with voice complaints. Participants with benign vocal fold lesions demonstrated higher VHI-30 scores, suggesting greater perceived impact of voice disorders on communication and occupational functioning. These findings are consistent with previous reports indicating that structural vocal fold lesions may substantially affect voice-related quality of life and professional voice performance. 9

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The present findings are also broadly consistent with studies by Roy, Van Houtte, and Sliwinska-Kowalska. 11-13 These studies demonstrated that teachers experience higher rates of voice problems compared with many other occupational groups due to increased occupational vocal load and workplace exposures. Although the current study was conducted with a clinic-based sample, the observed occupational and clinical patterns suggest that teachers in Georgia may experience occupational voice-related risks similar to those reported internationally.

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This study has several strengths. First, all participants underwent videostroboscopic examination performed by otolaryngologists experienced in voice assessment, allowing clinical confirmation of laryngeal findings. Second, the study incorporated clinical findings, occupational characteristics, self-reported symptoms, comorbidities, and patient-reported measures of voice handicap, providing a multidimensional assessment of teachers presenting with voice complaints.

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Several limitations should also be acknowledged. The study was conducted in a single specialized clinic and included only treatment-seeking teachers; therefore, the findings may not be generalizable to the overall teacher population in Georgia. The cross-sectional design does not allow causal relationships between occupational factors and voice disorders to be established. In addition, the study did not include a comparison group without voice complaints, and auditory-perceptual voice assessment by speech-language pathologists was not performed. Some occupational and behavioral variables were self-reported and may therefore be subject to reporting bias.

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Despite these limitations, the study provides important preliminary clinic-based evidence regarding occupational voice disorders among teachers in Georgia. The findings support the importance of preventive vocal health programs, workplace interventions targeting classroom acoustics and vocal load, and early referral for voice assessment among teachers experiencing persistent voice symptoms. The relatively small sample size may limit statistical generalizability.