From Deseret News archives:

Striking a cord

Therapy can help patients overcome vocal disorders

Published: Monday, April 24, 2006 11:44 a.m. MDT
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That's one reason the problem may be misdiagnosed. A girl was told she had asthma but didn't get relief from her medications when she gasped for air. Finally she saw an ear, nose and throat specialist, who recognized that her vocal folds were not opening well, making an incomplete airway.

While solutions may be surgical, hers wasn't. She learned maneuvers and exercises to open the vocal folds to create a better airway. She no longer makes frantic trips to the emergency room when she can't breathe. And she doesn't need inhalers or others medications.

Vocal folds open when we breathe. If you say "eeee," they close. In the case of laryngospasm, the act of breathing in closes them and it's hard to open the passageway from the trachea to the mouth.

It's frightening, but it won't kill you, Sauder says. You may pass out, which allows the folds to relax, solving the problem, at least for the moment. The girl had been going to the ER for years when she couldn't breathe, thinking at any moment she could die. Her problem was easily treated by speech therapy.

Some disorders are life-threatening, so it's important to get a proper diagnosis and whatever treatment is needed. It may be as simple as learning techniques to open a larynx that's slammed shut

Kristine Tanner, who has a Ph.D. in speech pathology, has seen many patients use different medications to help breathing and sinuses when the problem is really voice.

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For a lesion caused by the vocal cord's collision force, there are techniques to reduce the force. And they're not that hard to learn, she says.

Voice therapy sessions typically last about an hour once a week for however many weeks the condition dictates. Surgery is usually followed by speech therapy to achieve the best result, as well.

Singers need specialized therapy because the demands on their voice are different. The U. clinic is somewhat unique because it has a singing voice specialist on staff.

Techniques are similar to voice lessons, Tanner said, including posturing and physically manipulating the larynx and structures involved in voice production. The patient learns to regulate the amount of air that moves through.

Polyps are a common source of voice problems. The benign lesions usually occur on the mid-membranous portion of the vocal folds, which vibrate and receive the highest impact. A female's vibrate about 220 times a second, a man's half that. The force with which it comes together has significant effect, Tanner says. Polyps typically occur on one of the folds, creating asymmetry that changes the voice by not allowing complete closure. The result is a rough-sounding voice like Prim developed. It may also trigger a callous on the other side.

Voice therapy is usually the first step. "If you don't change what the person has been doing that led to development of the growth, they're likely to get another one. Or scarring," Tanner says.

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Image

Dr. Marshall Smith does a post-op examination on John Prim. Prim, a pastor at Southeast Baptist Church and chaplain for the Real Salt Lake soccer team, had a polyp, which had roughened his voice, removed from his vocal cord a week before this photo was taken.

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