Treatment Strategies
Vocal Hygiene
To maintain good voice quality:
· Get sufficient rest · Eat wisely and healthy · Maintain voice and brain · Stay hydrated. Drink 8 glasses of water a day · Employ the strong muscles of your lower abdominals to support voice · Be attentive for injurious voice symptoms of GERD (Serbalik) Voice Therapy
Voice therapy is a vocal intervention strategy by which a trained speech language pathologist instructs the client on how to efficiently use the vocal folds to make sound. This does not change the structure of the vocal folds but it can assist with augmenting vocal fold function (Verma, 2013). Voice therapy is a common first and for most the only treatment for voice changes as a result of the aging larynx. The pros and cons are:
Voice Lift Therapy
Voice lift therapy consists of techniques and exercises to rebuild the power source of the voice. It consists of structured aerobic retraining of the abdominal, respiratory, and back muscle systems. With voice lift therapy, in addition to the speech clinician, patients may see a singing voice specialist even if they are not singers. Using singing training for a speaker is like using running or jogging or for an individual wanting to run better. This therapy training is more than what the individual needs for daily speech, so when they are out in public speaking they are nowhere near their speaking limit. (ENT, 2014).
Only two voice therapy programs are research based and are effective for age-related voice changes lead to decreases in phonatory effort in age-related dysphonia and to increases in voice-related quality of life: phonation resistance training exercises (PhoRTE) and vocal function exercises (VFE). |
Phonation resistance training exercises (PhoRTE)
With this method the individual speaks with a narrow pharyngeal space, a wide mouth opening, spread lips, and a high laryngeal position-which arises with the vowel /a/, maximizes phonatory efficiency and loudness and aids in recalibrating the amount of phonatory effort. Those changes let a speaker to talk loud with no voice strain.
The PhoRTE program entails the four exercises below: 1. Hold a continuous vowel /a/. 2. Move from low to high and from high to low on the vowel /a/ over the whole pitch range. 3. Call out functional phrases. 4. Exercising the same functional phrases at a low pitch level (Ziegler & Hapner, 2013) |
Vocal function exercises (VFE)
VFE is a sequence of voice exercises that have been proven and described as voice maneuvers devised to balance airflow to muscular effort and to balance and strengthen the laryngeal musculature
The vocal function exercises entail the four exercises below that are to be done two times each, twice a day, seven days a week. Emphasis is on a frontal focus to the sound. 1. Sustain at maximum phonation the /ĩ/ 2. Rising glide over the whole pitch range on /oɫ/ 3. Declining glide over the whole pitch range on /oɫ/ 4. Sustain at maximum phonation on pitches middle C and D, E, F, and G on /oɫ/ (Ziegler & Hapner, 2013) |
Injection Therapy
Injection therapy involves a vocal fold injection of gel or paste that is added as a filler to the deep layer of the vocal folds, undoing the thinning process that the aging vocal folds undergo. This technique can be done in the operating room or in-office. This is not a permanent method and results may last from months to years (Verma, 2013).
It is also doable to inject a medicine or drug into one or both vocal folds to strengthen the voice. An injection of Botox into one or both vocal folds can assist individuals with laryngeal tremor or spasmodic dysphonia (ENT, 2014). Thyroplasty
Thyroplasty is a technique done in the operating room in which the vocal fold is physically moved closer to the opposite vocal fold to help produce sound. Thyroplasty is frequently used to fill large gaps and is made up of an implant put through a small opening in the neck to compress the laryngeal tissues. This can offset the thinning of the vocal folds (Verma, 2013).
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