Second only to our personal appearance, our voice is the most important way we present ourselves to the world. When it malfunctions, we lose a reliable communication tool. As Lord Byron pointed out, though, the voice can be used for more than just communication. It can be used to inspire and educate or it can be used to entice or tempt. Yet as Seneca noted, the voice is really nothing more than “beaten air.” He may have been referring to the habits of the long-winded Roman senators, but his comments very well describe a rough understanding of vocal production.
The understanding of the mechanics behind the production of voice has exploded over the past ten to twenty years. The physicians at Colorado Otolaryngology Associates have participated in expanding this new understanding of voice and the diseases which affect it. As a result, we are able to offer the latest in evaluations and treatments for those individuals afflicted with diseases affecting the voice.
Diseases of the voice may be broadly categorized into structural problems (Table I) and neurologic problems (Table II). In order to make a diagnosis and to distinguish between these two, it takes a skilled ear and the latest in diagnostic tools. We have committed to having those tools available, which may include flexible fiberoptic laryngoscopy as well as rigid laryngoscopy with or without stroboscopic examination. We record these evaluations both to share with colleagues and to compare at future visits. We even provide copies for patients upon request.
| Table I |
Table II |
| EXAMPLES OF STRUCTURAL PROBLEMS |
EXAMPLES OF NEUROLOGIC PROBLEMS |
| Polyps |
Unilateral cord paralysis |
| Papillomas |
Bilateral vocal |
| Nodules |
Parkinsonism |
| Sulcus vocalis |
Spasmodic dysphonia |
| Inflammatory changes from reflux |
Stroke |
| Cancer |
Myasthenia gravis |
| Dysplasia |
Once the diagnosis is made, we are ready to offer a treatment approach for the condition altering the voice. Occasionally that means working with a skilled speech therapist. We work with many regional speech therapists, each specializing in a specific area of voice or speech. Sometimes a neurologic evaluation is necessary, and we frequently work with neurologists in our region. Finally, interventions might include more invasive procedures depending on the problem. Examples include:
We take particular interest in treating the “professional voice user.” Included in this group are professional and recreational singers, ministers, teachers, salesmen, essentially anybody who uses their voice for employment or to participate in their avocation of singing or speaking to groups. Many times this requires a variety of medical treatments along with close co-treatment with a speech therapist or vocal coach.
Much of the time changes in voice occur as a result of behavior we have under our control. The National Center for Voice and Speech has compiled a comprehensive list of suggestions which may be viewed at www.ncvs.org. A short list of things to try are listed here.
We are very pleased to include a sophisticated approach to the evaluation and treatment of patients with voice disturbances for patients in the Colorado Springs region. We back our commitment to providing this care by obtaining the latest in training and equipment. Please let us know when we can return your voice to, as Lord Byron said, “an arrow for the heart.”