I’ve been talking just fine all my life! Why do I need to see a speech therapist?
Phonotrauma: Voice problems may result from a variety of causes. Some voice disorders such as vocal nodules or polyps, arise from how you use your voice. Other voice problems are the result of learned voice use patterns such as paradoxical vocal fold movement, or laryngeal hypersensitivity. The way you breathe, the pitch at which you speak, and the loudness of your voice all contribute to the amount of force with which the vocal folds collide when they vibrate during speech. The damage to the vocal folds from excessive vibrational collisions is called phonotrauma and can result in such tissue changes as nodules, polyps, and scarring.
It’s Multifactorial: Few voice problems have only one cause. When there is damage to the vocal folds, we tend to compensate for them to make the voice do what we need it to. This type of compensation usually involves muscle tension and can lead to further loss of the voice. Many voice problems have a component that can be helped by either re-learning how to use the voice, or intentional, guided exercises that can change the tissue’s vibrational properties. The speech pathologist, also known as a vocologist or voice therapist acts like a physical therapist to help the tissues of the voice heal properly, and to teach you the best way to make use of them. He is a speech-language pathologist with additional specialized training in vocal biomechanics. The vocologist will evaluate the functional use of your voice, and in collaboration with the laryngologist will design a treatment plan to help correct some of the problems with your use of the voice, and to promote healing of the tissues.
Professional Voice Users: Most people rely on their voices to do their jobs. Voice professionals such as singers, actors, and broadcasters rely on the quality of their voices to do their jobs. As such they can have greater difficulties when voice problems occur. These vocal athletes also place more demands on the voice, and can be at greater risk of voice problems. Because the voice is comprised of tissues, it changes in reaction to any illness, changes in health, age, or even sometimes the weather! Re-adjusting your use of a changing vocal instrument is something that the vocologist helps you with.
Repair the damage, remove the cause: Voice problems are multifactorial, and benefit from a combination of medical (surgery, medications) and behavioral (exercises, use of the voice) treatments. If you only fix the damaged vocal folds but not the use of the voice that caused the damage, you’ll likely end up back here in a year with the same problem.
Eugen Grabscheid MD Voice Center
Department of Otolaryngology –
Head & Neck Surgery
5 East 98th Street
New York NY 10029