Diagnosis and Treatment of Voice Problems

Effective treatment of voice disorders depends on correct diagnosis. At the Voice Center, sophisticated stroboscopic light sources are used to view the vocal folds in motion. Examinations are recorded for documentation and comparison. Treatment for voice disorders varies widely, depending on diagnosis. Voice disorders may be the first sign of a general disease or illness. The Voice Center keeps up to date with the latest research, therapy approaches and surgical options. Our team reviews vocal findings and develops a plan to remediate each voice disorder.

Karin Titze Cox, voice clinic director, is a speech language pathologist/singer with specialty training in voice (clinical vocologist). She provides stroboscopic evaluations of the larynx and comprehensive evaluations of the voice/resonance and swallow mechanism in the Salt Lake City and Murray locations. Ben Schiedermayer is also a speech language pathologist/singer and clinical vocologist that provides voice therapy after diagnosis. All members of our voice center staff with various ENT physicians in the practice to provide the best quality of care and outcomes for the patient.

Advice for Care of the Voice

The following are helpful hints for the care of the professional voice.

Hydration

The vocal folds need to be lubricated with a thin layer of mucus in order to vibrate efficiently. The best lubrication can be achieved by drinking plenty of water. A good rule of thumb is to drink as much water as possible. Dr. Palmer says “if (your output) is light it’s right”.

Caffeine and alcohol pull water out of your system and deplete the vocal folds of needed lubrication. Caffeinated drinks include coffee, tea, and soft drinks. Small amounts of these beverages are acceptable, but they must be counter balanced by drinking more water. Another factor that can affect lubrication is a dry air environment. The cause can be from gas furnaces, air conditioners, and climate with a low amount of moisture in the air. Using a cool mist humidifier at night can compensate for the dryness.

The air in airplanes is extremely dry. It is recommended that you drink at least 8 ounces of non-alcoholic and non-caffeinated liquid per hour while flying.

Throat Clearing and Harsh Coughing

Throat clearing and harsh coughing are traumatic to the vocal folds and should be reduced as much as possible. One of the most frequent causes for throat clearing and coughing is when there is thick mucus (due to dryness) or too much mucus (as with a cold) on or below the vocal folds. The safest and most efficient way to clear mucus is by using a productive cough where there is high air flow with little sound. This can be achieved by using the following procedure: take in as deep a breath as possible, momentarily hold your breath, push the chest and abdomen inward with as much strength as is possible, and produce a silent “H” sound while you expel the air.

Drugs

Antihistamines
Antihistamines are sometimes prescribed to treat allergies and are present in some over-the-counter cold medications. Antihistamines should rarely be used because they tend to cause dryness. Nasal steroid sprays such as Nasacort (Phone-Poulenc-Rorer), Nasonex (Schering), Flonase (Allen & Hansburys), etc. will often relieve the symptoms of the nasal allergy without the drying side effects of antihistamines.

Analgesics
Aspirin products and non-steroidal anti-inflammatory drugs (Ibuprofen) should be used with caution as they cause platelet dysfunction and this may pre-dispose to bleeding. Tylenol (McNeil Consumer Products) is the best substitute for pain relief.

Mucolytic Agents
Mucolytic expectorants (gauifenesin) help liquefy viscous mucus and increase the output of thin respiratory tract secretions. These drugs may be helpful for singers who complain of thick secretions, frequency throat clearing, or postnasal drip. Postnasal drip is often caused by secretions that are too thick rather than too plentiful. Mucolytic agents need to be used with good hydration to be effective.

Local Anesthetics
Avoid the use of local anesthetic over-the-counter preparations like the plague. Singing under their influence is like trying to play the piano with gloves on.

Progesterone
Question the use of progesterone dominant birth-control pills. They may cause virilizrion of the female larynx as it affects vocal fold fluid/swelling and a loss in the upper vocal range. There may be no other alternative for your individual situation, however, so consult your gynecologist.