Voice is the sound wave that makes speech and words to form language. Our voice is as unique and individual to us, as our own personality. Tone of Voice is profoundly more powerful and efficient at conveying meaning, than the actual words we speak. Words actually convey less than 10% of meaning. When we speak about voice we are referring to the movement of air, passing through tiny, flexible, rapidly vibrating muscles (vocal chords) that produce sound in the voice box (Larynx) in the throat. The voice box (larynx) is made of cartilage, muscle and mucous membranes, sitting at the top of the windpipe (trachea). See what normal phonation looks like below: (Sean Parker Institute for Voice)
When we speak about voice we are referring to the movement of air, passing through tiny, flexible, rapidly vibrating muscles (vocal chords) that produce sound in the voice box (Larynx) in the throat.
There are three main systems involved in voice production and each system is equally important. Voice production involves the synchronisation of over 100 muscles in the body, it is dynamic and complex. It involves breathing using your diaphragm. As air moves up from the lungs, it brings the vocal cords together causing the vibration of the vocal cords to make sounds. These are then shaped into words by the cavities of the mouth and nose.
Our voice is designed to last us a lifetime with due care and respect, however a range of variables can affect it. If your vocal cords become inflamed, develop growths or become paralysed they won’t work correctly and you may develop a voice disorder.
We know that some people are more likely to develop voice problems due to physical, emotional, personality, occupational factors and illness. Vocal changes such as hoarseness (breathy, rough, raspy or strained sounding voice) or vocal fatigue (voice sounds normal but may be effortful to produce daily and very tired after prolonged speaking) are the most obvious initial signs of a voice problem.
A voice disorder is a persistent change in someone’s voice quality (persistent hoarseness). The voice may often be hoarse, rough, strained, husky or soundless (aphonic). Frequently the voice will be weaker and less powerful. Many report they have a feeling of discomfort/ tightness / tension, dryness or a lump in the throat feeling. Voice Disorders can range in severity from mild to severe. Partial voice loss is known as dysphonia, while complete voice loss is known as aphonia. Voice problems can affect anyone of any age, including children.
(a) Structural e.g.inflammation, (laryngitis) or the growth of nodules, aging
(b) Neurogenic (involving the nerve innervation to the larynx) e.g. vocal cord paralysis ( post surgery), laryngeal cancer.
People with voice disorders often experience difficulties in day-to-day life, such as talking on the telephone, in social situations, at school or in fulfilling their employment
People with voice disorders often experience difficulties in day-to-day life, such as talking on the telephone, in social situations, at school or in fulfilling their employment particularly when their voice is used throughout the day. People who experience voice disorders frequently report feelings of isolation, frustration and stress, that others may not understand in relation to their voice. Most voice problems can be reversed by treating the underlying cause or through a range of behavioral and surgical treatments. Occasionally vocal changes can indicate more significant changes or serious difficulties.
Laryngitis is temporary swelling of the vocal folds due to a cold, or acute upper respiratory infection, or allergies. It is the most common cause of hoarseness. Your doctor will treat laryngitis according to its cause,e.g. For (1) a cold or upper respiratory infection, your doctor might recommend rest, fluids, and nonprescription pain relievers. (2) Allergies might be treated similarly, with the addition of over-the-counter allergy medication.
Cheering at sporting events, speaking loudly with force in noisy situations, talking for too long without resting your voice, singing loudly, or speaking with a voice that's too high or too low can cause temporary hoarseness.Treatment usually includes resting, reducing voice use, and drinking lots of water, which should help relieve hoarseness from misuse or overuse.
Sometimes people whose jobs depend on their voices—such as teachers, singers, or public speakers—develop hoarseness that won't go away.
If you use your voice for a living and you regularly experience hoarseness, your doctor might suggest voice therapy by seeing a Speech & Language Therapist. In voice therapy, you'll be given vocal exercises and tips for avoiding hoarseness by changing the ways in which you use your voice.
GERD, commonly known as heartburn can cause hoarseness as stomach acid rises up the throat and irritates the tissues. Usually hoarseness caused by GERD is worse in the morning and improves throughout the day. In some people, the stomach acid rises all the way up to the throat and larynx and irritates the vocal folds. This is called laryngopharyngeal reflux (LPR). LPR can happen during the day or night. Some people will have no heartburn with LPR, but they may feel as if they constantly have to cough to clear their throat and they may become hoarse. GERD and LPR are treated with dietary modifications and medications that reduce stomach acid.
These are benign (noncancerous) growths within or along the vocal folds. Vocal nodules are sometimes called "singer's nodes" because they are a frequent problem among professional singers. They form in pairs on opposite sides of the vocal folds as the result of too much pressure or friction, much like the way a callus forms on the foot from a shoe that's too tight. A vocal polyp typically occurs only on one side of the vocal fold. A vocal cyst is a hard mass of tissue encased in a membrane sac inside the vocal fold.
The most common treatments for nodules, polyps, and cysts are voice rest, voice therapy, and surgery to remove the tissue.
This occurs when a blood vessel on the surface of the vocal fold ruptures and the tissues fill with blood. If you lose your voice suddenly during strenuous vocal use (such as yelling), you may have a vocal fold hemorrhage. Sometimes a vocal fold hemorrhage will cause hoarseness to develop quickly over a short amount of time and only affect your singing but not your speaking voice. Vocal fold hemorrhage must be treated immediately with total voice rest and a trip to the doctor.
This is a voice disorder that occurs when one or both of the vocal folds don't open or close properly. It can be caused by injury to the head, neck or chest; lung or thyroid cancer; tumors of the skull base, neck, or chest; or infection (for example, Lyme disease). People with certain neurological conditions e.g. stroke, may also experience this. In many cases, however, the cause is unknown.
Vocal fold paralysis is treated with voice therapy and, in some cases, surgery.
Diseases and disorders which affect areas of the brain that control muscles in the throat or larynx can also cause hoarseness. Hoarseness is sometimes a symptom of Parkinson's disease ( due to reduced breath support), or a stroke. Spasmodic dysphonia is a rare neurological disease that causes hoarseness and can also affect breathing. Treatment in these cases will depend upon the type of disease or disorder.
These can both cause hoarseness. Hoarseness may sometimes be a symptom of laryngeal cancer, which is why it is so important to see your doctor if you are hoarse for more than three weeks. Hoarseness is also the most common symptom of a disease called recurrent respiratory papillomatosis (RRP), or laryngeal papillomatosis, which causes noncancerous tumors to grow in the larynx and other air passages leading from the nose and mouth into the lungs.
Do I have a Voice Disorder? If you answer yes and have concern about one or more of these, you should seek reassurance and medical advice from your doctor.
Imaging tests. X-rays and MRI can show growths or other tissue problems in the throat.
Speech and language therapists (SLTs) have an important role in diagnosing voice conditions using comprehensive assessment, treatment and promoting a healthy voice.
The SLT will meet with you to explore and actively listen to your description of the vocal problem by taking a case history and performing clinical assessment
SLT Assessment may include
Healthy habits to take care of your voice