There are numerous factors that can cause problems with the voice:
- Heavy voice use (teachers, singers, performers, etc.).
- Chronic cough or persistent throat clearing.
- Smoking.
- A virus or illness.
- Acid reflux (LPR or GERD).
- Allergies.
- Inadequate breath support.
Hoarseness may also result from swelling, chronic irritation, or a learned pattern of muscle tension with voicing. These common factors can create persistent hoarseness that does not simply go away with time. In addition, certain benign or cancerous growths can occur on the vocal cords and cause alterations in the voice and sometimes swallowing. If a patient experiences ongoing hoarseness that lasts for several weeks, the patient should see a doctor for a thorough evaluation.
An evaluation for a voice disorder usually begins with a visit to the Ear, Nose, and Throat physician. The physician may order a videostroboscopic examination to access the structure and function of the patient’s larynx (voice box).
Videostroboscopy uses modern video and digital imaging technology to examine the voice box during the production of voice. The study gives high-resolution video images of the voice box in slow motion, so that the vocal cord may be carefully studied. This also provides a nice opportunity for each patient to see his or her voice box and have a better understanding of his/her voice problem. This study is performed at Eastern Carolina ENT Head & Neck Surgery.
Once the videostroboscopic evaluation has been completed, the physician will confirm a diagnosis and implement a plan of care to best treat the voice disorder. Treatment of voice disorders ranges from speech therapy to medical therapy or even surgical therapy, depending on the particular diagnosis. In many cases, speech therapy is the only form of treatment required. Speech therapy is appropriate for patients with vocal nodules, muscle tension dysphonia, vocal misuse or overuse, patients with weakness of their vocal folds, and patients who are post-op from surgery for their vocal cords, as well as numerous other problems with the voice. Speech therapy is catered to the specific diagnosis for each patient.
Speech therapy may include any of the following:
- Providing the patient with specific information on the type of problem or vocal instrument abnormality present, and the most likely causal factors.
- Explaining how the above is/are interfering with normal voice production.
- Describing the necessary coordination of the breathing and speech systems to produce.
- normal voice.
- Assigning the patient out-of-clinic activities designed to make them aware of his/her daily vocal use.
- Identifying daily vocal abuse patterns and working on strategies to eliminate them.
- Implementing strategies to establish more appropriate daily vocal hygiene and vocal health.
- Specific work on elimination of vocal muscle tension.
- Specific work on establishing appropriate breath support and speech breathing patterns.
- Specific work on strengthening the vocal fold muscle for a stronger voice.
Speech therapy is often initiated with home exercises given the same day as the videostroboscopic examination. Follow-up with formal office visits may be indicated by each patient’s specific needs and diagnosis.
Medical therapy for voice disorders most commonly includes treatment for acid reflux. Patients are encouraged to follow some dietary restrictions which will reduce the symptoms associated with acid reflux in the throat. A medication may also be used to reduce the amount of acid production. Medical therapy may also include treating an underlying cause of the hoarseness.
Surgical therapy is sometimes necessary for certain structural abnormalities found during videostroboscopy.
Call Eastern Carolina ENT Head & Neck Surgery at 252-752-5227 for more information or to schedule an appointment.
