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Therapy, new surgery techniques help in healing voice disorders

Published: Tuesday, June 5 2012 11:24 a.m. MDT

SALT LAKE CITY — Singers aren't the only ones who should worry about taking care of their voices.

Experts say losing your voice can have a profound effect on your physical and emotional well-being, particularly for those whose livelihoods depend on their vocal cords.

People can experience short-term injury to the voice from yelling at an athletic event or from a cold or sore throat. Those types of injuries should recover within a month.

“It's when there's repetitive injury that some tissue damage can result,” said Dr. Marshall E. Smith at the University of Utah's Voice Disorders Center. “Most problems with the voice can be treated without surgery but with medical management and therapy.”

Surgery was what injured Unified police officer Paul Burnett's vocal folds or cords, and he needed further surgery in addition to therapy to restore their full use.

Twelve years ago, Burnett had parathyroid surgery that paralyzed his vocal cords and damaged the nerves. It's a common complication of any type of neck surgery, Smith said.

The right side of Burnett’s vocal folds were paralyzed in an open position, which not only affected Burnett's voice, but his breathing as well.

“When the vocal fold is paralyzed, one side isn't moving and the vocal folds cannot close,” said Smith. “And there's a gap or a space in between them.”

Smith said that gap limited Burnett’s duties as a police officer and activities when off-duty.

“If I were to go sprint somewhere as fast as I could, I’d be out of breath,” said Burnett. “Not in the sense that my lungs couldn't take the air, it was that I couldn't get the air to my lungs.”

He switched from a patrol car to a desk job. The paralysis on his vocal cords took a toll on Burnett’s family, social and professional life.

“For the longest time I couldn't speak into the next room. People would have to know that they'd have to come up close to me to hear me. Or if we'd go on a camping trip or something down by the stream or (somewhere with) loud noises,” said Burnett. “Now it's not quite that severe. But out of doors is still much more difficult than inside an office to speak.”

Smith said going through voice therapy will help strengthen Burnett's voice muscles.

“Just like the athlete who develops a limp, or a strain, or a muscle pull needs to go to a physical therapist to get the muscles re-balanced and get moving again, speech pathologists who work with us in our voice clinic get patients' voices moving again,” Smith said.

Doctors at the Voice Disorders Center are also trying new surgical techniques on some patients to better heal voice disorders.

“We graft in a nerve from another nerve in the neck to the paralyzed nerve to give it more tone,” said Smith. “And that procedure is giving good results.”

Sitting in a chair at the Voice Disorders Center, Burnett holds a microphone to his left neck and mimics sounds to Smith’s. Simple “eeks” during therapy sessions are considered progress.

While the right side of his vocal folds is damaged, therapy on the left side allows the voice to reverberate to the sound and cause vibrations to the paralyzed right side, stimulating it.

Smith said Burnett is healing "as well as we can hope for given the condition that he has.”

Burnett has learned that even simple things like cold weather and acid reflux can do some damage to vocal cords.

“I can usually speak better in the warm weather,” he said.

For the acid reflux, Burnett eats a few hours before bedtime and watches what he eats to avoid potential problems.

Smith said that’s excellent advice for any patient, since many voice disorders are caused by inflammation, muscle tension in the neck and allergies. Smith also recommends taking medications and elevating your bed for patients with acid reflux.

These days, Burnett's smooth baritone voice is a little more gravely than he'd like. So he warns others not to take their instrument for granted.

“I had no control over my voice condition but there are a lot of things such as smoking that can affect your voice, yelling too much.,” said Burnett. “If you think you have a problem such as acid reflux that affects not just your throat but your voice, situations you might have the ability to control, I would strongly suggest you have it looked at.”

Preventing voice disorders

• Avoid smoking

• Drink plenty of water

• Use a microphone to talk to large groups or when speaking frequently

• Warm up the voice before speaking/singing

• Practice breathing techniques

• Avoid screaming or yelling

Appointments at the Voice Disorders Center are available by calling 801-587-3549.

E-mail: niyamba@ksl.com

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