Baptist Health provides therapy to persons with voice disorders caused by nodules, overuse or misuse of the vocal cords.

What is a voice disorder?

A voice disorder causes the voice to draw attention to itself. This may be a voice that sounds hoarse or harsh, has too high or too low a pitch or a shaky voice.

How does the larynx/voice box produce sound?

The larynx is made up of two cartilages that are suspended in the neck by a series of muscles that connect to the jaw and collarbone. This allows the larynx to rise and fall slightly in the neck during speech and singing. Inside the larynx are two vocal cords which are covered with a thin membrane of moist tissue. These vocal cords vibrate when air passes over them, much like the reed in a wind instrument. The vocal cords vibrate very quickly. For example, in women the vocal cords may vibrate 230/second. This vibration produces sound.

What is the cause of a voice disorder?

The otolaryngologist will examine the vocal cords to determine if there is a physical reason for the voice problem. Sometimes growths have formed on the vocal cords from overuse or in reaction to some trauma. The vocal cords may be inflamed and swollen from overuse. Sometimes the vocal cords look normal but the voice does not sound normal. There is a relationship between gastroesophageal reflux (heartburn) and certain voice disorders. The acid from the stomach may "burn" the vocal cords.

How does a physical change in the vocal cords cause my voice to sound different?

If you have a growth on your vocal cords, such as nodules, the cords are not able to close tightly. This is similar to trying to close a door when your foot is stuck in the door. If the vocal cords cannot close tightly and smoothly, the voice does not sound good. If the voice disorder has been caused by misuse or overuse, the cords might be slightly swollen and red (what we call laryngitis) or they may even be slightly bowed. This keeps the cords from closing smoothly.

If I have a growth on my vocal cords why can't my doctor remove it surgically?

Otolaryngologists often recommend speech/voice therapy to see if surgery can be avoided. Many times voice therapy is successful in reducing the size of, or eliminating, the growths. Even if surgery is needed, voice therapy is still a good idea as you will learn better ways to use your voice. If the growth is removed and you continue to use your voice as you always have, the growth may return.

What if the doctor can't see anything wrong with my vocal cords, but my voice still sounds bad?

Sometimes the vocal cords look healthy, but the voice still sounds hoarse. This is probably due to misuse of the cords. The speech-language pathologist can teach ways to use the vocal cords to regain and keep a healthy voice.

What can a speech-language pathologist do to help my voice?

The speech-language pathologist may use a variety of techniques, including:

• Helping you identify ways you may be misusing your voice, such as talking too loudly, yelling, talking at too high or low a pitch, etc.
• Helping you identify ways you are overusing your voice, such as talking all day at work, singing at night, etc. A healthy voice can be used throughout the day without problems. However, if you have a voice disorder and continue to use your voice as much as you have in the past, it will wear out.
• Teaching you ways to use your voice that will help it sound better. These activities may include learning the correct way to breathe. You produce sound with your voice box as you exhale. If you have developed faulty breathing patterns, this may be affecting vocal quality.
• Teaching you exercises for your vocal cords so your voice lasts longer.
• Using a computer to help you see how you are using your voice and help you achieve the best pitch and loudness to keep your voice healthy.

Will my insurance pay for voice therapy?

Each insurance plan is different, but because voice disorders are related to something wrong with your vocal cords, there is a good chance that your insurance will pay.