Voice Disorders

Voice Therapy




WHAT IS VOICE THERAPY ?
Voice Therapy is a mode of treatment for a patient with a voice disorder, which includes:
A vocal hygiene program
Relaxation and breathing techniques
Voice therapy exercises, including exercises for strengthening the vocal cords, relaxing and breathing exercises and exercises for improve
WHAT DOES A VOICE THERAPIST DO?

The voice therapist plays an important role in the diagnosis and treatment of voice disorders.

The diagnosis is made by the following means :

Perceptual assessment
Acoustic analysis
Spectrographic analysis
Aerodynamic measurements

ACOUSTIC ANALYSIS

This is in conjunction with an endoscopic and video stroboscopic examination of the vocal cords, done by an otolaryngologist.
Following the diagnosis of the voice disorder by the otolaryngologist and the voice therapist, the treatment options are discussed and decided upon. This may include surgery, voice therapy or a combination of both.
The voice therapist provides the behavioural mode of treatment. The voice therapy is conducted over several sessions, by means of a one-to-one interaction between the patient and the therapist. During these sessions, the various modes of the therapy are demonstrated and taught to the patient, so that he can follow the required regime independently and at home Special voice software programmes are used to monitor the improvement in voice quality and provide feedback to the patient.

WHAT IS THE SCOPE OF VOICE THERAPY ?


Various voice problems can be successfully managed by voice therapy :

- Vocal cord lesions due to vocal hyperfunction (voice misuse and abuse) such as vocal nodules, polyps, cysts and vascular lesions can be treated by voice rest and an individually designed vocal hygiene programme.

- Vocal hypofunction disorders like bowing of cords and unilateral or bilateral vocal cord palsy can be treated by a regime of exercises for strengthening the vocal cords.

- Functional aphonia and spasmodic dysphonia can also be managed successfully by relaxation and breathing exercises.

- Voice therapy is a part of post operative care for patients operated for vocal cord lesions and also following such procedures as thyroplasty, botulinum toxin injections and Teflon paste injections.

- Post laryngectomy voice rehabilitation with the help of artificial larynges, voice prostheses and oesophageal speech.

- As can be seen, the voice therapist and the voice surgeon work in close coordination with each other and form the central figures in the large team which makes up a voice disorder clinic.

VOICE REHABILITATION OF LARYNGECTOMISED PATIENTS


The surgical removal of the larynx or laryngectomy is a traumatic experience for the patient, not only because of the loss of a vital organ, but also because of the loss of the power of speech. The laryngeal cancer patient, who is already mentally depressed due to his disease, finds himself in a socially unacceptable position after losing his voice. Thus, the voice rehabilitation of laryngectomised patients is an essential part of rebuilding their lives after surgery.


At the Vasant Oswal Voice Clinic, we are actively involved in helping the laryngectomised patient to learn to "speak" all over again.
There are a number of options available for the patient to regain the ability to communicate verbally

Esophageal Speech The patient is taught to produce a "voice" by belching out air trapped in the esophagus - this is then articulated to form comprehensive words.
Artificial Larynx

A number of electronic and mechanical devices are available, which create a constant sound or "voice".
The patient is then taught to articulate and form words and thus "speak".

Voice prostheses These are simple valve type mechanical devices, which are inserted into the throat of the patient and use the patient's air stream to produce voice.

It must be kept in mind that voice rehabilitation of a laryngectomised patient requires a lot of motivation and psychological support. For this purpose a Larnygectomee Club is being formed by the voice clinic, which will consist of a speech language pathologist, laryngologist, social workers and rehabilitated laryngectomees.


DEENANATH MANGESHKAR HOSPITAL & RESEARCH CENTER