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Vocal Hygiene: how to get the best mileage of your voice

Voice is a critical aspect of effective and healthy communication, and World Voice Day is a worldwide event which happens on April 16th every year, the main goal is to increase global awareness to the need for preventing voice problems, rehabilitating the deviant or sick voice, training the artistic voice, and researching the function and application of voice.

Speech and voice are the result of a complex interplay of physical and emotional events. The first event is in the brain: a desire or need to communicate. The brain formulates ideas and feelings and translates them into language and transmit the signals to muscles throughout the speech mechanism.

In the respiratory system, muscles contract to compress air in the lungs, thus forcing it to flow upward through the trachea (windpipe) and larynx (voice box). This action supplies the power source for vocal fold vibration and speech sounds during a spoken phrase.















As the respiratory system is preparing to provide the airflow, the two vocal folds (in the larynx) begin to approximate each other. Once they are sufficiently closed, the airflow from the lungs sets them into vibration. As long as the vocal folds are close enough to provide some resistance to the breath stream, and relaxed enough to vibrate, tiny puffs of air will be released between the vocal folds as they alternately open and close. The vocal folds vibrate between 100 and 300 times a second during speech! The resulting succession of air pulses creates a sound wave in the vocal tract. The sound wave passes through the upper vocal tract, including the throat and mouth. The tongue, jaw and lips, alter the sound wave as it passes through the mouth.

Normal voice production depends on power and airflow supplied by the respiratory system; laryngeal muscle strength, balance, coordination, and stamina; and coordination among these and the supraglottic resonatory structures (pharynx, oral cavity, nasal cavity).

A disturbance in one of the three subsystems of voice production (i.e., respiratory, laryngeal, and subglottal vocal tract) or in the physiological balance among the systems may lead to a voice disturbance. Disruptions can be due to organic, functional, and psychogenic causes.


Causes of voice disorders


Organic causes include the following:


Structural:

  • Vocal fold abnormalities (e.g., vocal nodules, edema, glottal stenosis, recurrent respiratory papilloma, sarcopenia [muscle atrophy associated with aging])

  • Inflammation of the larynx (e.g., arthritis of the cricoarytenoid or cricothyroid, laryngitis, laryngopharyngeal reflux)

  • Trauma to the larynx (e.g., from intubation, chemical exposure, or external trauma)

Neurologic:

  • Recurrent laryngeal nerve paralysis

  • Adductor/abductor spasmodic dysphonia

  • Parkinson's disease

  • Multiple sclerosis

Functional causes include the following:

  • Phonotrauma (e.g., yelling, screaming, excessive throat-clearing)

  • Muscle tension dysphonia

  • Ventricular phonation

  • Vocal fatigue (e.g., due to effort or overuse)

Psychogenic causes include the following:

  • Chronic stress disorders

  • Anxiety

  • Depression

Signs of a Voice Problem


You should make an appointment to see an ENT and Speech therapist if you experience any of the following symptoms for more than 2 weeks (not accompanying a cold):

  • sore throat or pain during or after voice use

  • hoarse, scratchy, rough voice

  • increased effort when producing voice

  • decreased loudness or pitch range

  • breathiness, weakness or vocal fatigue

  • shaky, strained voice or voice cutting off unexpectedly

  • feeling of a “lump” in one’s throat

  • shortness of breath

  • excessive phlegm and/or the need to throat clear or cough

  • difficulty swallowing

  • feeling a frequent urge to cough or throat clearing


Treatment


Treatment for a voice disorder depends on what is causing it. Speech language pathologist (SLP) often team with otolaryngologists and other medical professionals like, Pulmonologists, Gastroenterologists, Neurologists, Allergists, Endocrinologists and develop treatment plans to support the medical plan and to optimize outcomes.

Voice therapy is an important part of treatment for many voice disorders. Voice therapy is designed to treat the most common underlying cause of voice disorders: voice misuse and abuse. Voice therapy is often combined with other treatment approaches. Some lifestyle changes may help reduce or stop symptoms. These can include not yelling or speaking loudly and resting your voice regularly if you speak or sing a lot. Exercises to relax the vocal cords and muscles around them can help in some cases. Warm up the vocal cords before extensive periods of speaking. Stay hydrated.


How to Get the Best Mileage from Your Voice