There are several options for therapy and treatment of voice problems (dysphonia). To read about how your voice works, Click Here.
To read about what causes voice problems, Click Here.
Avoid Misuse and Vocal Abuse
Often, repairing voice problems from misuse just requires an individual to change their lifestyle and avoid certain activities. It may also involve learning relaxation techniques and changing the way you use your voice. To change the way you use your voice we must focus on our breathing style so that our lungs are doing the work, not our larynx. A qualified Speech and Language Therapist / Pathologist will be able to talk you through the relevant exercises. If therapy is unable to fix the problem, then surgery to remove growths such as nodules or cysts is also an option. However, although surgery usually has a successful outcome, it is important to know that unless you tackle the underlying problem that caused the voice problem initially, it may re-occur.
Coping with Injury
It will depend on the nature and extent of the injury as to how much your voice will improve. Vocal fold paralysis is one possible result following injury and can also occur after an individual has had endotracheal intubation following a coma or an operation. When one vocal fold is damaged or paralysed, surgery can sometimes improve voice. The paralysed vocal fold can be “bulked up” with another substance such as Teflon, collagen or body fat, and this reduces the space between the 2 folds allowing the working fold to meet the paralysed fold. Alternatively, surgery to push the paralysed vocal fold closer to the centre of the larynx may be performed. The working fold can then make better contact with the paralysed fold and voice is improved. Treatment will also involve speech therapy following surgery.
Coping with Disease and Illness
As with injury it depends on the nature and extent of the disease. Treatment may involve physical therapy, speech therapy and/or possibly surgery.
Coping with Laryngectomy
The extent of the voice loss will depend on the extent of the laryngeal removal, but it is highly likely that whatever the extent of removal there will be voice difficulties following such surgery. For many, there will be total voice loss. However, in recent years certain surgeries have been performed that have given laryngectomy patients new hope. In 1998 the first successful larynx transplant was carried out in Cleveland, America, and some patients successfully use devices such as the electro-larynx or artificial larynx. Other patients master esophageal speech, or have a tracheo-esophageal puncture which allows them to produce esophageal speech more easily.
If you have concerns about your voice, visit a qualified speech therapist /pathologist for assessment and speech therapy.
Taking care of our voices – a healthy voice
As mentioned in the first section, if you have a “croaky” or unhealthy voice is often a symptom of an unhealthy person. Lifestyle plays a huge part in the health of our voice, so try and follow some simple rules:
Breathe correctly – breath from the diaphragm and take deep breathes before you speak. Do not continually talk until you run out of air. If you breath shallowly (from your chest, rather than from your stomach), you are not using your breath for speech correctly and not supplying as much power for speech as you could. See our Download Section for breathing exercises to facilitate voice care.
Have a good posture – good posture will help with your breathing technique.
Stay hydrated – drink lots of water continually through the day. Avoid drinking too many caffeinated drinks or too much alcohol.
Try to relax – a major cause of voice disorders is stress. Excess tension will effect your posture, your breathing, and the muscles of your throat and neck which impacts on your voice. If you are experiencing voice problems, find time each day to relax.
Avoid clearing your throat or whispering – many people with voice difficulties feel the need to constantly clear their throat, and are often doing this without thinking about it. Throat clearing can really aggravate voice difficulties. Some therapists suggest either doing a hard swallow or taking a sip of water rather than throat clearing. Contrary to what many people believe, whispering is not good for protecting your voice, because the vocal folds have to work harder when whispering.
Stop smoking – try to stop or reduce smoking as the smoke passes directly over the vocal folds. Smoking can cause respiratory illness, laryngeal cancer and other health problems which can all impact on voice.
Awareness of your occupation – does your job involve a lot of talking? Apart from changing you job, there are a number of things you can do to help protect your voice. Drink lots of water and breath from the diaphragm (see above) before you speak. Try to avoid talking or shouting when it is not absolutely necessary and find some times in the day to relax and unwind. If your occupation involves breathing in dust and/or fumes, try and find some way to reduce your exposure.
Do you take medication? – be aware that certain medications such as inhalers can coat the pharynx and vocal folds, drying them out. One way to help, is to stay well hydrated and drink lots of water. Talk to your doctor if you feel that your medication may be effecting your voice.
Do you suffer from reflux? – If you suffer from reflux at night this can also cause voice problems. If you think this might be causing your problems, see your doctor for some relevant medication.
Avoid work environments that are smoky or dusty
Look after your health and your diet and avoid activities that put a strain on your voice. If you keep loosing your voice or it is continually hoarse, go and see your doctor and ask for a referral to an ENT (ear, nose and throat) specialist or a speech and language pathologist / therapist.
For more information about communication difficulties, and ideas and strategies to help communication, see our Resources, or for specific fact-sheets with helpful hints about Adult Speech Difficulties go to the Downloads section.
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