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Voice Conditions

Ela Britchkow

Everyone has a unique voice. A voice is a problem when the pitch (too high or low for oneís gender), loudness (too loud or too soft), or quality (hoarse, breathy, nasal) calls attention to itself rather than to what the speaker is saying. It is also a problem if the speaker experiences pain or discomfort when speaking or singing.

Voice is produced when the vocal folds ( often called vocal cords) come close together and air from the lungs sets them vibrating. Some sounds (p, t, k, s, sh, f) are produced without voice. All vowels and some consonants (d, g, z, v) are voiced.

Organic voice disorders include issues secondary to cancer, vocal fold paralysis, endocrine changes, granuloma, hemangioma, papilloma, laryngeal web, chronic atrophic laryngitis, myasthenia gravis, and laryngeal leukoplakia

Functional voice disorders arise when the voice is used improperly. People can become hoarse temporarily by cheering at a football game or by misusing the voice by talking too loudly or using a pitch level that is too high or too low. A voice problem can also occur due to an improper breathing pattern. Abuse also occurs with nonverbal vocal behavior such as excessive throat clearing, laughing, crying, coughing and smoking. Misuse and abuse can cause physiological changes to the vocal folds, creating vocal nodules, polyps, contact ulcers and edema. In the case of yelling, the vocal folds come together in a hard way. As they bang together repeatedly, swelling can occur, and eventually a blister can form. When the vocal folds are swollen or have a nodule/polyp, they canít come together as closely as they normally do, the vocal folds vibrate in an irregular fashion and the result is a hoarse sounding voice.

Therapy for functional disorders involves identifying abuses and misuses and reducing or eliminating them. Treatment by a speech-language pathologist is an important component in the successful resolution of these vocal fold disorders

It is important to rule out an organic basis before staring voice therapy. A referral to an ear, nose and throat specialist (ENT) or an otolaryngologist is necessary to rule out an organic voice disorder.

My voice is hoarse due to a cold!

    If you catch a cold (upper respiratory tract infection) or have allergies, that cause you to have a hoarse voice, there are things you should and should not do. Pitch should not be lowered and volume should be moderate. Some voice experts recommend raising the pitch so that you are speaking at an optimal level above the cold or respiratory infection. No voice rest. This may be harmful since the voice produced after voice rest is usually at a lower pitch and non-use of the vocal folds can lead to flaccidity of the vocal folds and more voice problems. Donít whisper. This causes the already irritated and swollen vocal folds to continue to come together and vibrate.

    In treating the voice, the speech-language pathologist helps individuals identify the particular types of abuse and misuse in which they are engaging, and then works with them to set up a plan for reducing and/or eliminating these behaviors. They establish a plan for good vocal hygiene together, working cooperatively.

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