Voice Disorders

Tips to prevent voice problems: 9 Stay hydrated:

• Drinkplentyofwater.6-8glassesadayisrecommended.

• Limityourintakeofdrinksthatcontaincaffeine,whichcancausethebodytolosewaterandmakethevocalfoldsandlarynxdry.

• Useahumidifierinyourhome. 9 Maintain a healthy lifestyle and diet:

• Don’tsmokeandavoidsecond-handsmoke.• Avoideatingspicyfoods.• Getenoughrest.Physicalfatiguehasanegativeeffectonvoice.

• Exerciseregularly:exerciseincreasesstaminaandmuscletone.Thishelpsprovidegoodpostureandbreathing,whicharenecessaryforproperspeaking.

• IfyouhavepersistentheartburnorGERD,talktoyourdoctoraboutdietchangesormedicationsthatcanhelpreduceflare-ups. 9 Use your voice wisely:

• Trynottooveruseyourvoice.Avoidspeakingorsingingwhenyourvoiceishoarseortired.

• Restyourvoicewhenyouaresick.Illnessputsextrastressonyourvoice.

• Avoidusingtheextremesofyourvocalrange,suchasscreamingorwhispering.Talkingtooloudlyandtoosoftlycanbothstressyourvoice.

• Practicegoodbreathingtechniqueswhensingingortalking.

• Avoidcradlingthephonewhentalking.Cradlingthephonebetweentheheadandshoulderforextendedperiodsoftimecancausemuscletensionintheneck.

• Considerusingamicrophonewhenappropriate.Inrelativelystaticenvironmentssuchasexhibitareas,classrooms,orexerciserooms,alightweightmicrophoneandanamplifier-speakersystemcanbeofgreathelp.

• Avoidtalkinginnoisyplaces.Tryingtotalkabovenoisecausesstrainonthevoice.

• Considervoicetherapy.Aspeech-languagepathologistwhoisexperiencedintreatingvoiceproblemscanteachyouhowtouseyourvoiceinahealthyway.

SLP 16-016 1437/20161437/2016

Preparedby:SpeechLanguagePathology

King Faisal Specialist Hospital & Research CentreCorporate Social Responsibility

P.O.BOX3354Riyadh11211KingdomofSaudiArabiaTel:+966114647272

Website: www.kfshrc.edu.sa

What is Voice?Itistheproductionofthevibrationofthevocalfoldsthatarelocatedinthelarynx,orvoicebox.Whenyoutalk,aircomes fromyour lungs, throughyourvocalfolds,thenthevocalfoldsvibratetoproducesound.The vocal folds can elongate or shrink to producehighorlowvocalpitch.

What causes voice disorders?There are two types of causes:

1. Organic voice disorders: organicvoicedisordersfall into two groups: structural and neurogenic.Structuraldisordersinvolvesomethingphysicallywrongwiththemechanism,ofteninvolvingtissueorfluidsofthevocalfolds.Neurogenicdisordersarecausedbyaprobleminthenervoussystem.Forexample:9 Cystsandpolypsinwhichagrowththatformsbeneath the surface layer of the vocal foldmucosa that affects the vocal quality andcauseshoarsenessanddiscomfort.9 Laryngealcancercanalsocausevoicedisorders,andinseverecasesitmightrequirelaryngectomy(removalofthelarynx)9 The voice may be impaired in persons withotherneurologicdiseasessuchas:Parkinson’sDisease, Myasthenia Gravis, AmyotrophicLateral Sclerosis (ALS, a.k.a. Lou Gherig’sdisease). The voice may also be impaired inpersons who suffer a stroke or other braininjury and have damage to any part of thespeechsystem.9 Spasmodic Dysphonia (SD) caused by aproblem in the nervous system. It can affectmany parts of the body, andwhen it affectsthelarynx,thevocalfoldsvibratenormally,buttheyspasmintermittentlyduringspeech.9 Upperrespiratoryinfections.

2. Functional voice disorders:Afunctionaldisordermeans thephysical structure is normal, but thevocal mechanism is being used improperly orinefficiently.Includes:• Continuousyelling/shouting• Heavysmoking• Gastricrefluxifnottreated• HyperadductionorHyperabduction

Voice Disorders When to call your doctor or speech pathologist for voice problems?

• Ifyourvoiceishoarse,soundsdifferenttoyou,orifitispainfultotalkformorethan10days.

• Ifyouloseyourvoiceeasilywhentalking.• youhavetoworkhardtospeak loudlyenough

tobeheard.• If so, an ENT should assess your vocal folds

and rule out voice problem using instrumental assessments.

How does a speech pathologist help in voice problems?

• AfteryourENTconsult,thedoctorwillreferyoutospeechlanguagepathologyforanassessmentofyourvoice.

• The speechpathologistwill askyouabouthowyouuseyourvoiceandwhatproblemsyouarehaving, listen to you talk and assess your vocalquality, pitch and loudness, work with you toimprove your voice and help you learn goodvoicehabitstolessenvocalabuse.

What is the Normal Voice?A person’s voice can be judged as within normallimitsifthepitch,loudnessandqualityisappropriatetotheperson’sageandgender.

What does a voice disorder sound like?You may sound hoarse or breathy, or like you aretalkingoutofyournose,whichiscalledhypernasality,like you have a cold and are stuffed up, calledhyponasality,as ifyourvoice istoohighortoolow,called a pitch problem, or like you are talking tooloudlyortoosoftly.

You may sometimes lose your voice when you are speaking and have the urge to frequently throat clear or cough.