Marshall E. Smith, M.D., Laryngologist and Medical Director of the Voice Disorders Center
People who use their voice for a living, such as teachers and singers, are more likely to develop voice problems. But anyone, from children to adults, can become victim to voice disorders through an illness, surgery, medications, or even yelling too much at the soccer game.
What is a voice disorder?
A voice disorder is defined as any time the voice does not work, perform, or sound as it should so that it interferes with communication.
How common are voice disorders?
A recent study said 30% of American adults have experienced a voice disorder in their lifetime. About 7% of adults at any one time have a voice disorder. The percentage increases in patients with vocally demanding professions-teachers, broadcasters, and singers, and telemarketers-who use their voices for hours each day.
When should someone consider being seen by a specialist?
If someone has persistent hoarseness, difficulty speaking, throat pain, vocal fatigue, or difficulty being understood by others for more than 3 weeks, they should consider making an appointment with an ear, nose, and throat specialist. Diagnosis of voice difficulties is best done by a multi-disciplinary team that includes a laryngologist, speech-pathologist, and singing voice specialist for patients who are also singers. The team gets a detailed history, listens to the voice during a number of specific voice tasks, and uses special equipment called stroboscopy to view vocal fold vibration.
What are the most common voice disorders?
Most voice disorders are caused by problems with the function of the larynx or voice box and the vocal folds that are housed within the larynx. The vocal cords must be able to vibrate and open and close properly or the voice is impaired.
Patients who have had thyroid, spinal or thoracic surgery often have a voice disorder because the nerves to the larynx are often damaged during those procedures, causing vocal fold paralysis.
How is vocal fold paralysis treated?
Dr. Smith performs a unique re-innervation surgery where he takes another nerve in the neck and sews it to the damaged or paralyzed nerve so that it can grow and restore tone to the vocal cord. (He is the only physician in the region to offer this treatment.)
Re-innervation has become a viable option over older techniques such as thyroplasty or fat injection. It is also offers a permanent solution over botox injections, which must be done every few months. Re-innervation gives the voice more volume and the voice doesn't fatigue as quickly.
What are some other treatment options?
Depending on the diagnosis, some patients may take medication, participate in voice therapy (includes voice exercises and massage) or undergo surgery. Most patients with voice disorders do not need surgery. Approximately 80% of patients seen at University Health Care's Voice Disorders Center see results with medical management and voice therapy. For the other 20%, surgery is required to help restore voice quality and strength.
Specialists at the Voice Disorders Center can often help people who have been told their voice disorder is permanent. The Center's multi-disciplinary team includes laryngology, speech pathology, and vocal pedagogy (or singing specialist).
For more information on voice disorders, call University Health Care's Voice Disorders Center at 801-587-3549 or visit www.healthcare.utah.edu/voicecenter.
