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Voice Disorders and Voice Therapy

Posted on January 7, 2010 at 4:35 PM

TherapeuticVoiceWork encompasses many notions about vocalizing, singing and therapeutic methods for treatment and improving the voice. There are many areas of study with respect to voice therapy and several physiological and neurological voice disorders. However, there are psychological components effecting voice production and they are the focus of this article. Itis helpful to have a basic understanding of how sound is produced bythe vocal chords and other parts of the voice and helpful to have alittle knowledge about various physical disorders and treatments.

Vocal Hygiene

All voice rehabilitation should include the elimination of vocally abusivebehaviors such as throat clearing, habitual yelling or screaming,habitual breath holding, or glottal attack. Inhaled irritants such astobacco and toxic chemicals should be avoided. Gastroesophageal reflux,or chronic heartburn should be controlled. Itis important to not allow yourself to become dehydrated and you shouldfollow proper levels of fluid intake. Medications with drying potentialshould be minimized to optimize laryngeal hydration.

Five Main Categories of Voice Therapy:

Symptomatic voice therapy addresses the identification and elimination of vocallyabusive behaviors through facilitating approaches. These techniques facilitate a target or a more optimal vocal response by the patient.  Examples include auditory feedback, head positioning, laryngeal massage, and relaxation. Disorders of misuse or abuse benefit from this treatment philosophy. Psychogenicvoice therapy addresses the underlying emotional and psychosocialissues that are causing the dysphonia. People suffering from conversion dysphonia would benefit from this approach. Etiological voice therapy focuses on recognition and elimination of the cause(s) of the voice disorder(s). Muscle tension dysphonia may benefit from this approach. Physiologicvoice therapy, a type of biofeedback, involves the use of acoustic and aerodynamic analysis to direct the patient's vocal function back to objectively normative physiologic voice function.

Physiologic voice therapy may be useful on a patient with falsetto. Two alternate classifications of voice therapy techniques -

Direct and Indirect;
Direct techniques focus on voice production and include techniques such as the yawn-sigh method, optimal pitch establishment, and laryngealmanipulation. Indirect techniques focus on reducing the etiologic factor that cause the voice problem and include auditory training and patient education. Through a meta analysis, comprehensive voice therapy was effective in improving vocal performance in adults with Functional Dysphonia.

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