Voice difficulties might include chronic hoarseness, aphonia (absence of voice), low/high pitch, or strained/strangled quality. An otolaryngologist (ENT) must first perform a laryngoscopic examination where they are able to view the vocal folds (voice box) in real time. This examination is necessary to rule out the presence of the following:
Vocal fold nodules are benign growths on either one or both vocal folds that are caused by vocal abuse (yelling, excessive throat clearing etc.). They may also be caused by acid reflux. Over time, repeated misuse of the vocal folds results in soft, swollen spots on each vocal fold that develop into harder, callus-like growths. The nodules will become larger and stiffer the longer the vocal abuse continues.
Vocal polyps take a number of forms and are sometimes caused by vocal abuse. Polyps appear on either one or both of the vocal folds and appear as a swelling or bump (like a nodule), a stalk-like growth, or a blister-like lesion. Most polyps are larger than nodules and may be called by other names, such as polypoid degeneration or Reinke's edema.
While rare in children, cancer must be ruled out before therapy can begin with them as well as adults.
What is Vocal Hygiene?
Your voice, and the body mechanisms that produce voice, are meant to last a lifetime. But the vocal mechanism cannot tolerate excessive wear and tear. There are good habits –– things you can do to take care of your voice. A Speech-Language Therapist can guide you in taking care of your voice and overcoming and preventing some voice problems. Vocal hygiene is positive change –– suggestions that will make you feel better and make you sound better too!
Voice therapy involves teaching good vocal hygiene, eliminating vocal abuses, and direct voice treatment to alter pitch, loudness, or breath support for good voicing. Stress reduction techniques and relaxation exercises are also an important part of therapy.
The purpose of voice therapy is to help you attain the best possible voice and the most relief from those symptoms that are bothering you. Voice therapy programs generally are made up of an educational component and a technical skills training component. The educational component includes an overview of normal, healthy voice production and vocal hygiene habits. The majority of the time spent in therapy sessions focuses upon the technical skills training component. This training consists of exercises to help coordinate breathing, producing sound and achieving the pitch, loudness and quality of the sound you desire in a way that is healthy for the vocal folds. The specific type of technical skills training will depend upon your specific voice disorder –– the symptoms you are experiencing and the underlying cause.