Voice care is provided for adults and children, including professional voice users such as teachers, lawyers, salespersons, clergy and others who require good voice for their occupation. We also work with singers who experience impaired technique related to their voice disorder. All patients receive a full voice assessment prior to therapy. Patients are required to have a laryngeal examination by an Ear, Nose, and Throat doctor (Otolaryngologist) before therapy begins.
Associated in part with voice abuse/misuse:
Vocal nodule – a small, benign callous-like growth usually on the edge of each vocal fold at the point where the folds meet with maximum pressure when voicing. Voice therapy is the primary treatment.
Polyp – a benign, fluid filled, blister- like growth usually appearing on one vocal fold (but often creating a rough edge on the opposing vocal fold from contact). It can vary in size and often requires surgical removal. Voice therapy can facilitate healthful voice production that can improve voice quality and reduce the chance of recurrence even if surgery is required.
Cyst – a fluid filled sack, thought to result from a blocked mucous gland within the vocal fold. The resulting mass is benign but often requires surgical removal. As with a polyp, voice therapy can improve voice technique to relieve excessive voice stress and prevent recurrence even if surgery is required.
Contact Ulcer (Granuloma) – often associated with high stress voice use and gastric reflux, this involves the formation of an ulcer-like irritation in the cartilage toward the back of the vocal folds where they press together for speech. Granuloma tissue (rough tissue irritation in the same area) can be associated with intubation from surgery as well. Treatment can include increased voice rest, therapy, and reflux medication.
Muscle Tension Dysphonia – characterized by vocal hoarseness, roughness, and sometimes throat discomfort and fatigue which progresses with increased voice use, without an actual vocal fold pathology. This is due to incorrect use of the throat muscles when speaking.
Neurogically based voice disorders include:
Vocal fold paralysis and paresis (weakness) – a vocal fold movement disorder in which one vocal fold (infrequently both) does not open or close normally, usually creating a significantly weakened voice or voice loss. This can result from injury or neurologic insult, as well as for unknown reasons often associated with an upper respiratory illness or unknown cause. This condition is not usually considered permanent until at least a year has passed. Voice therapy can improve control over voice production, sometimes improving quality and projection as long as the vocal folds make adequate contact.
Spasmodic dysphonia – characterized by a strained-strangled voice quality, this voice disorder most often presents in a patient’s 40’s, possibly a predisposed condition triggered by a stressful time or event. There is no cure and periodic botulinum toxin injections are considered to be the primary mode of management. Voice therapy is limited to strategies that may help ease the patient into speech.
Laryngeal Tremor– characterized by a shaky, tremorous voice. There is no cure and short term voice treatment is limited to finding strategies to ease voice production.
Progressive Neurologic Diseases can include voice disorders characterized by reduced loudness and projection, quality and resonance. Patients with these diseases may also have changes in speech articulation as well.
Presbylarynx, a weakened and often breathier voice associated with normal aging, is characterized by difficulty projecting the voice to achieve adequate loudness. A combination of voice therapy to strengthen vocal fold muscles and sometimes surgical procedures can make a significant impact on functional communication.
Paradoxical Vocal Fold Motion (Vocal Ford Dysfunction) – periodic episodes thought to be triggered by irritants and often associated with reflux, in which the vocal folds fully or partially close causing noisy strained breathing, coughing and a sensation of tightness in the throat. In teenagers, this condition is often associated with stress related to high expectations in competitive sports. Voice therapy focuses on relaxation and breathing with exercises to promote easy breathing with improved patient control.
Frequently asked questions:
Q: Why is my doctor referring me for voice therapy?
will happen in the voice evaluation?
Q:What is voice therapy and how often will I attend?
Q:How long does a course of voice therapy last?
Q:What can I do to improve my vocal health even before starting