Voice injuries can take time to resolve, as most of us use our voice frequently throughout the day. Early diagnosis and appropriate intervention are key in addressing voice disorders. Steps in diagnosis include:-
Speech Pathologist assessment and intervention – Some speech pathologists specialise in voice therapy. The speech pathologist can provide a comprehensive assessment of the voice, and develop a range of voice exercises to help minimise any vocal strain or overuse. If there are concerns about the vocal quality and lack of response to treatment, the speech pathologist may suggest a referral to an ENT Specialist would be appropriate, for the purposes of a vocal cord examination.
Referral to an ENT Specialist who specialises in voice injuries – Just like any specialist, some ENT Specialists are experts in managing sinus injuries, injuries to the ear, auditory system or managing voice injuries. Best practice is to ensure an appropriately experienced ENT Specialist is contacted for an appointment. The ENT Specialist can then complete a direct examination of the vocal cords via fibreoptic laryngoscopy and stroboscopy (which looks at the movement of the vocal cords, whether there are any obstructions on the vocal cords, the anatomy and musculature of the larynx etc). The ENT Specialist can also provide advice as to the effectiveness of treatment to date and alternative or additional treatment options.
Active Tip: Simple prevention measures and simple additional treatment can include:
- Always keep hydrated with constant sips of water when using your voice
- Try to keep the humidity high in your environment
- A plant in the room can increase humidity and purify the air
The ENT Specialist may recommend surgery if there is evidence of a cyst or polyp. If voice therapy does not help resolve vocal cord nodules, surgery may be suggested to remove these. Additionally, if there is significant scarring on the vocal cords, surgery may be considered to remove the scarring, although this may not necessarily resolve the problem.
Some ENT Specialists recommend vocal cord injections as an adjunct to voice therapy. The injection material helps “plump up” the vocal cords to align them closer together. The injection wears off over a period of months and voice therapy during this time can help modify the vocal behaviours that created the voice disorder.
Sometimes a more “permanent” procedure may be required, and the ENT Specialist may recommend a laryngoplasty to insert some material into the vocal cords that is not reabsorbed by the body.
Some people with voice injuries report ongoing pain in their throat which is not resolved through voice therapy or ENT Specialist intervention. Referral to an appropriately qualified physiotherapist or remedial massage therapist can be helpful to provide myofascial release therapy – working on the muscles of the throat to relieve the tightness and strain. Some people have found acupuncture helpful in releasing the tension in the muscles of the throat.
Modification of voice usage
Treatment may not be effective without looking at the behaviours that impacted on the voice in the first place. A review of, and changes to the work environment (including looking at the acoustics of the work environment), modification of the vocal load, equipment to support the voice are all strategies to assist someone with a voice injury. Referral to a rehabilitation provider with appropriately qualified and experienced consultants like Active OHS can assist with this. It is important to utilise a consultant who understands the physical and psychological impact a voice injury may have on the person, and one who understands how these restrictions can impact on the person, both from a workplace and personal perspective.