Can we keep our voice healthy? Know How

Dr.Radhamadhab Sahu
HOD ENT & Skull Base Surgery
Sum Ultimate Medicare

Bhubaneswar, Apr 16: Every year on April 16, otolaryngologist-head and neck surgeons and other voice health professionals across the world join together to recognise World Voice Day. On World Voice Day, everyone – young and old – is encouraged to assess their vocal health and take action to improve or maintain good voice habits.

Conditions like aging and swallowing, aspiration, Cricopharyngeal muscle dysfunction, dysphagia, hoarseness, sore throats, vocal cord paralysis, Laryngeal cancer etc affect the voice to a great extent.

Many ENT-related symptoms may seem to be related to one specific region of the ears, nose, and throat while, in fact, they could also point to something entirely different. Nasal conditions like sinusitis, deviated septum, nasal neoplasms, and rhinitis and throat conditions like gastro-oesophageal reflux, laryngopharyngeal reflux, dysphagia, tonsillitis, and adenoids are such symptoms.

What to do in such conditions?
A complete care of the voice starts with careful use of your voice and maintaining good hydration and vocal habits. The voice plays an important role in communicating at work, at home, and in social situations.

A wide variety of things can cause a change in your voice and can present as hoarseness, an increased effort to speak, or diminished strength of your voice. Any change in your voice lasting more than three weeks should be investigated and you should be examined by your doctor or an ENT (ear, nose, and throat) specialist .

Factors like smoking (also the main risk factor for laryngeal carcinoma), excess alcohol consumption, gastro-oesophageal reflux, professional voice use – eg, teachers, actors and singers, environment: poor acoustics, atmospheric irritants and low humidity, type 2 diabetes (neuropathy, poor glycaemic control) can cause voice disorders.

How to Evaluate ?
Fiberoptic laryngoscopy - Its a flexible tool to examine the larynx and voice box

Stroboscopy : Stroboscopy is used to visually slow down the vibration in order to facilitate assessment. It uses a flexible or rigid endoscope combined with a microphone and a flashing strobe light. The microphone is placed next to the larynx and is used to estimate the fundamental frequency of the voice.

Narrow-Band Imaging (NBI) is an endoscopic technology using optic filters to select two wavebands from a cold light source. Coupled to high-definition video-endoscopy, it enhances contrast in superficial mucosal vascularisation imaging. In our institute we use NBI technology with flexible laryngoscopy to differentiate between benign and malignant lesions of larynx and pharynx. This treatment method has been developed recently for head and Neck cancer evaluation. This is a tool which can indentify head and neck  malignancies in very early stage.

A person suffering from vocal cord paralysis may witness the following symptoms:
• Voice changes—Hoarseness, breathy voice, weak voice, gurgling quality to the voice, shortness of breath after speaking.
• Airway problems—Shortness of breath with efforts, noisy breathing, unsuccessful cough.
• Swallowing problems—Choking or coughing when swallowing food, drink, or saliva, and food sticking in throat.

Treatment:
With the development in science and technology, there are several treatment methods for vocal cord paralysis, like speech therapy , Cord medialisation surgery , Vocal cord Injection, laryngeal reinnervation.
In order to maintain a healthy voice and reduce voice disorders, these following measures should be kept in mind:
Dos:
1. Drinking plenty of water daily
2. Use of amplification (microphone or megaphone) in large noisy spaces can help reduce shouting and voice strain
3. Rest your voice briefly to prevent voice fatigue, straining and overuse
4. Provide indoor air humidification in dry arid environment
Don’ts:
1. Smoking and second hand smoke from cigarettes, cigars and pipes that can irritate your airway
2. Overuse, misuse and abuse of voice by yelling, shouting, speaking over loud noises and whispering
3. Excessive throat clearing and coughing.