What are the most common voice concerns?

Communicating (speech and singing) and eating a meal all involve this vital area. Also specific to otolaryngologists is expertise in managing diseases of the larynx (voice box) and the upper aero-digestive tract or esophagus, including voice and swallowing disorders.  

The primary causes of voice concerns in adults are:

• Hoarse, strained, weak, or breathy vocal quality

• Difficulty producing a loud voice

• Pain or discomfort when speaking or singing

• Increased effort to talk

• Frequent laryngitis

• Voice fatigue

• Decrease in pitch range

• Changes in voice after trauma

What conditions cause voice problems?

• Upper respiratory infections

• Gastric reflux disease

• Environmental issues

• Vocal cord trauma and misuse

• Vocal polyps (growths)

• Laryngeal cancer

• Neuromuscular diseases (including spasmodic dysphonia)

• Psychological stress

At Premier ENT, we provide state-of-the art services to improve voice, swallowing, and speech related problems. We conduct thorough reviews of each individual case, taking into consideration any medical, surgical, lifestyle, occupational, or emotional factors that may be contributing to the patient’s complaint. This results in a precise, rapid diagnosis of the underlying causes of the disorder and a treatment program tailored to individual needs. We are proud to provide comprehensive care for consultation and rehabilitation in a friendly and compassionate environment.

The Diagnostic Process

Voice testing typically includes:

• Consultation with an otolaryngologist: An initial medical exam by an ear-nose-throat doctor to rule out any medical conditions associated with the throat and voice.

• Transnasal flexible laryngoscopy with videostroboscopy: A state-of-the-art test that involves placing a tube into the nose with a special strobe light that shows the vibration of the vocal folds to reveal any irregularities.

• Clinical voice evaluation: A perceptual assessment by a speech-language pathologist of muscle tension, voice quality, pitch, loudness level, resonance, breathing patterns, and prosody; Diagnostic therapy with a speech-language pathologist to determine potential for voice change.

• Acoustic analysis: Recording and measurement of the voice, in order to compare the voice to norms and to monitor voice over time; This includes perturbation measures, spectrography, and electroglottography, which determines the amount of vocal fold contact during vibration.

Treatment for Voice Disorders

You will likely see both an otolaryngologist and a speech-language pathologist, who will collaborate with you to develop a plan specific to your needs and goals.

• Visits with the otolaryngologist typically take 15 to 30 minutes.

• Sessions with the speech-language pathologist take 30-45 minutes.

• Therapy and speech training is typically scheduled 1-2 times per week, and typically lasts from 2 to 8 weeks, depending on the concern.

Voice treatment may include:

• Medication to target associated medical conditions

• Surgery to remove growths in the larynx, and/or

• Behavioral voice therapy to address muscle tension, breathing patterns, and voice production, including:

• Exercises for relaxation, breathing patterns, and voice production

• Counseling regarding voice use at home and work, and food/liquid intake related to voice

• Communication strategies to compensate for voice

Voice therapy for professional voice users, including singers, actors and public speakers, such as attorneys and teachers:

• Warm-ups and strategies during performance or work

• Speaking vs. singing technique

• Safe projection

• Applying new skills to performances or the work setting

• Vocal hygiene and voice conservation when necessary.