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Do You Have a Problem with Your Voice?

A normal speaking voice is very important to effective communication. We have all experienced transient voice difficulties during an upper respiratory infection or following attendance at a loud concert or sporting event. When this occurs, our ability to talk with others can be quite challenging. Fortunately, this problem usually subsides in a week or less, and then voice returns to normal. If the quality of your voice has changed substantially, and this condition has persisted for more than two weeks, examination of the voice box by a throat specialist should be conducted no matter what you may believe is the cause. In most cases, the problem is due to benign swellings of the vocal cords caused by abusive behaviors, such as yelling, screaming, excessive throat clearing, or uncontrollable coughing spells. In other cases, however, the cause may be more serious, such as vocal cord paralysis or cancer. In planning for your examination by the Ear, Nose and Throat specialist, you can expect to undergo several examination procedures to determine the cause of the voice difficulty and the best methods for treating the problem.

Common Examination Steps:Vocal cord examination

Vocal Cord Examination

  1. The doctors will ask questions about your a) voice problem history, b) overall medical condition, including recent surgeries, c) smoking and drinking habits, and d) routine voice behaviors at work and at play.
  2. The doctors will listen carefully to your voice and may perform computerized tests to evaluate the type and degree of your voice problem.
  3. A slow motion video vocal cord examination will be performed by the doctor using either a slim rigid scope, like the one shown above, or a thin flexible tube. In most cases this exam takes about one minute to conduct, followed by a thorough review of the results with you.
  4. For completeness, a general examination of the ears and nose will also be performed.
  5. On occasion, certain findings during the vocal cord examination may lead to the recommendation for additional procedures, including endoscopy and biopsy in the operating room, CAT scan examination in the Department of Radiology, or both.
  6. After all testing has been completed and the diagnosis has been reached, treatment alternatives will be discussed with you, as described below.

Treatments Based on Your Voice Examination Results:

  1. Vocal hygiene regimen to eliminate voice abuse habits.
  2. Hydration program consisting of at least 8 glasses of water per day, and avoidance of dehydrating caffeinated beverages.
  3. No food or drink within two hours of bedtime. If signs of acid reflux irritation are observed during the vocal cord examination, reflux medicines may be prescribed.
  4. Avoidance of allergens (e.g., dust, pollen) that may cause abusive coughing and throat clearing behaviors; allergy medicines may be prescribed.
  5. Cessation of cigarette smoking.
  6. On occasion, a short course of steroids may be prescribed or injected to alleviate acute or chronic vocal cord swelling.
  7. Voice therapy may be ordered to help guide more effective speaking behaviors.
  8. Some growths and vocal cord paralysis may require surgery to recover voice, swallowing, and breathing abilities. For vocal cord cancer, a unique treatment approach is necessary, including any one or more of the following options: surgery, radiation therapy, and chemotherapy.

Caveats:

If you or your loved one are experiencing voice difficulties that have lingered for more than a couple of weeks, it would be wise to make an appointment to see an Ear, Nose and Throat doctor to rule out all serious causes and to discover the most effective treatment plan to help restore voice.

Drs. Valenti and Amjad practice out of the Harper professional Office Building, Suite 1007. Appointments can be made with either of them by calling: 313-966-9471. Office hours are from 9:00 to 5:00 M-F.

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