Women tout treatment received at voice clinic

Published: Thursday, April 16 2009 12:00 a.m. MDT

Speech pathologist Dan Houtz massages Jane Bergstedt's vocal chords at University of Utah's Voice Disorders Center. Bergstedt, a teacher, has a vocal chord polyp.

Tom Smart, Deseret News

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As a kindergarten teacher, Jane Bergstedt loves to talk, but she has to take a day off work each week to give her voice a rest.

Lacy Park lost her voice following surgery to remove a thyroid gland tumor and began choking whenever she ate or drank.

Jodi Carson's voice became little more than a whisper following her surgery to remove a mass in her neck, leaving her unable to warn her two small children of potential danger.

Though each had taken her voice for granted before the problems began, the women now agree their quality of life has improved dramatically after treatment at the University of Utah's Voice Disorders Center, which offers at least one treatment option not available elsewhere in the Intermountain West. A recent study showed nearly 30 percent of American adults have experienced a voice disorder during their lifetime.

Those who suffer from chronic, unexplained choking; hoarseness; impaired sound quality; or other voice problems are invited to a free screening today from 8 a.m. to 5 p.m. (See accompanying box for details.)

Both Carson and Park suffered from a paralyzed vocal cord after their surgeries and had sought to remedy the problem with various kinds of therapy and treatment without success.

Bergstedt has a vocal cord polyp, much like a blood blister, that made it exhausting for her to not only speak constantly with two classes of kindergarten students, but to conference with their parents. Her condition is caused by trauma or overuse of the vocal cords, which sports fans sometimes experience when they scream loud and long.

Though all of those conditions have their own unique causes, specialists at the clinic say they can usually help people who have been told their voice disorder is permanent, opening a world of clear communication their patients had lost before treatment. Techniques include voice therapy, massage, and Botox injections to the vocal cord folds.

Dr. Marshall Smith, the clinic's medical director, said many of the most common voice disorders have to do with how the vocal cords are able to vibrate and whether they open and close together properly. Both speaking and singing voices can be affected, and specialists treat both types of disorders.

It's fairly common for patients who have had thyroid, spinal or thoracic surgery to have voice disorders, he said, because vocal cords and nerves are often damaged or cut during those procedures. In many of those cases, he performs a unique "re-innervation surgery," in which he treats a paralyzed or damaged vocal cord by taking another nerve from an adjacent area of the neck and sewing it into the paralyzed nerve, where it can grow and provide better functionality.

Though the procedure was first discussed in the 1920s and reintroduced in the 1980s, it didn't catch on widely, Smith said, and relatively few specialists perform the surgery. The procedure "doesn't restore total nerve function to the vocal cord fold," but it provides muscle tone in the area where it had been lost.

"If you look at it as the kind of electricity that powers a light bulb, rather than the full 100 watts getting to the bulb, you'll get 10 to 20 watts — just enough to help the muscle" close against the adjoining vocal cord.

"It gives the voice more volume, and the voice doesn't fatigue so quickly," he said.

Both Park and Carson had the surgery and found a new world of communication reopened to them after years of feeling silenced and frustrated, as their voices returned, they said.

While 20 percent of patients at the clinic require some kind of surgery to help restore voice quality and strength, 80 percent see results with medical management and voice therapy alone, Smith said.

Bergstedt, who has a substitute come to her classroom each Wednesday so she can take a day off to rest her voice, said she's seen improvement in the past month since being referred to the clinic.

Her therapy consists of voice exercises and massages, which she will likely continue for another month.

Dan Houtz, a speech pathologist who was doing voice therapy with Bergstedt on Wednesday, said her problems "are not that uncommon," particularly among teachers, attorneys, broadcasters, telemarketers and customer service representatives who use their voices professionally for hours each day.

Bergstedt previously had a vocal cord polyp removed, but it has returned, and specialists are now working to see if they can solve the problem without resorting to surgery again.

"I actually look forward to coming" to the clinic, she said. "It gives me new tools to help manage my job. My students need a teacher who can be excited and enthusiastic, and it's hard to do that without my voice."

Smith said some patients experience dramatic improvement in voice quality in one 45-minute visit, depending on their particular challenges and the type of therapy available to deal with them.

Carson, who works as a physical therapy assistant, said life after her surgery is "a beautiful thing. I don't have to think about my voice any more. There was a point in my life where I wondered if it would always be hard to talk, but I don't even think about it anymore."

E-MAIL: carrie@desnews.com

Free voice screening

The University of Utah Voice Disorders Center, 729 Arapeen Drive in Research Park, is offering free voice screening today from 8 a.m. to 5 p.m. Advance registration is required. Call 801-587-3549 to reserve a spot. For more information, see the Web site at www.healthcare.utah.edu/voicecenter.

The University of Utah Voice Disorders Center, 729 Arapeen Drive in Research Park, is offering free voice screening today from 8 a.m. to 5 p.m. Advance registration is required. Call 801-587-3549 to reserve a spot. For more information, see the web site at www.healthcare.utah.edu/voicecenter.Free voice screening

The University of Utah Voice Disorders Center, 729 Arapeen Drive in Research Park, is offering free voice screening today from 8 a.m. to 5 p.m. Advance registration is required. Call 801-587-3549 to reserve a spot. For more information, see the Web site at www.healthcare.utah.edu/voicecenter.

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