Do you suffer from any of the following symptoms?

• Hoarseness

• weak voice

• dry throat

• varying speech (outliers)

• difficulty in controlling breath

• creaking voice

• pain when using your voice

If so, you may have a voice problem and are advised to consult a doctor.

• singers

• actors

• radio and television presentators

• teachers

• animators

• politicians

• representatives

• merchants

• telephonists

Contact a specialist when:

• your hoarse voice or voice problem does not disappear after three weeks

• you have swallowing problems or you are short of breath

Make an appointment

The following factors can cause voice problems:

• smoking (active or passive)

• drugs

• aspirin and other blood-thinning medication

• alcohol

• medication with a drying effect (e.g. sleeping pills, nerve medication, etc.)

Yes, smoking can definitely affect the voice. It dillutes the voice quality. These are common causes:

• Can increase reflux

• Can increase the need to cough and thus make your voice worse

• Smoking also causes lung failure. Without proper breathing, controlled by the lungs, singing is impossible and speaking can be made more difficult

• Smoking polyps can be formed and / or cancer can develop on the vocal cords

Yes, stomach acid can irritate the throat (larynx) and affect your voice quality. This condition is called laryngo-pharyngeal reflux. This disease can be prevented by changing the time, type and amount of food you eat and by avoiding alcohol and caffeine. It also helps to raise your head 30 ° at night by placing a block under the legs of the head end of your bed.

Drinking enough water is good for your voice. The vocal cords vibrate 100 to 400 times per second and require constant humidification. Avoid drinking beverages that contain caffeine such as cola, tea and coffee. If you drink such drinks anyway, it is best to drink additional water. The appropriate amount of water is 6-8 glasses / day.

Vocal ligths are small callouses on the vocal cords. They occur in both boys and girls, but especially in the female gender.

Vocal ligths are caused by:

• Voice abuse in the form of calling, shouting and whispering

• Use your voice in the wrong way

• Singing loudly or singing incorrectly

• Unnatural speech pitch

One can develop a cancer in the larynx. This can also occur on the vocal cords. Smoking significantly increases the chance of developing cancer. Alcohol and certainly the combination of smoking and alcohol use also have a damaging influence on the voice and stimulate the development of cancer.

Voice therapy involves an individual treatment method that focuses on changing the voting behavior that can cause voice disorders or that can prevent normal use of the voice.

Voice therapy involves the following:

• Indirect therapy (eg gaining insight into stem rest and voice hygiene)

• Direct voice therapy (eg postural adjustments, resonance exercises, voice placement, specific voice exercises or specific methods such as nasalization)

• Voice coaching (eg voice optimization, presentation techniques, singing techniques)

The ENT doctor usually prescribes 6 months of speech therapy with an interim evaluation at the ENT doctor after 3 months. Depending on the progress you make and the clinical findings, the further policy will be discussed in consultation with the doctor and speech therapist.

Voice therapy is given by a speech therapist. The best thing is that this person is specialised in the treatment of voice problems (voice therapist).

A list of speech therapists who specialize in the treatment of voice problems is available at 'de Stemkliniek'. You can make a selection based on this list.

For some voice problems such as vocal cord paralysis, vocal cord lumps, polyps, cysts etc. an operation is indicated and this can solve your voice problem.

If you need to undergo surgery, it is always advisable to follow speech therapy. The speech therapy is aimed at preventing vocal cord lumps or other illnesses from returning.

Just like an athlete is more likely to have muscle injuries, the larynx of a singer or word artist is exposed to a higher risk of a voice problem. Many diagnostic and treatment procedures for high-risk performers are similar to the techniques used by more current voice abusers. These techniques have, however, been greatly improved and organised in recent years. Certain procedures, however, are more specific for the 'high risk' group and the training and voting hygiene measures are more refined and adapted. For example, we can regard the 'high risk' group of singers and actors as the 'Olympic athletes' of the professional voice users with pronounced demands and voice expectations in which the diagnostic and therapeutic methods must be applied to the utmost.

Every voice problem and certainly with a professional voice user should be seen as a unique diagnostic puzzle. Voice problems with singers or actors can be expressed through a complaint (eg increased wild air, increased day to day variability) or due to limitations of the voice (eg loss of treble, difficulty with high and soft singing, more effort should be made) when singing or acting, decreased endurance). The problem usually occurs when more of the voice is asked, and few have problems with the normal speaking voice.

A specialized voice examination can find the cause here. It goes without saying that discovering this is an absolute condition to find the best treatment. A voice examination should be done by a foniater (this is a Ear-Nose-Throat specialist with special skills in voice reading), together with a speech therapist. The start of the problem is discussed. Attempts are being made to identify possible influencing factors. The seriousness of the complaints is examined as well as the motivation for rehabilitation. Subsequently, auditive perception analysis examines the singing voice possibilities and limitations such as the maximum vocal range, loudness possibilities, control possibilities, maximum phonation time, etc. The tuner itself is visually examined by means of a strobolaryngoscopy. While speaking, the vocal cords are viewed in their full function. With a special exposure technique (stroboscopy) the moving vocal chords are displayed in a delayed phase so that very small underlying imperfections or deviations can also be detected.

The voice is then taken up in a voice lab and objective voice parameters can be checked via certain voice exercises.

Afterwards the aforementioned findings are all discussed and instructions given to treatment options.

Recommended reading:

• Bastian RW. Vocal fold microsurgery in singers. J Voice. 1996; 4: 389-404.

• Ingram DB, Lehman JJ. Management or high-risk performers in clinical practice. Current Opinion in Otolaryngology & Head and neck Surgery. 2000; 8: 143-152.

Monitoring / maintaining good voice hygiene This is based on basic rules for voice hygiene with respect to smoking, alcohol, coffee, responsible use of medication, fluid intake, as well as limiting vocal risk behavior such as talking or singing with excessive background noise.

Limiting the voice activity Personality is an important factor in causing minor injuries (polyps, vocal cramps, etc.) on the vocal cords and is equally, or more important than vocally demanding occupations. Singers are advised to limit their vocal output both personally and socially (eg choral activities). Short sessions with the singing teacher with the emphasis on applying good sound singing technique is desirable with avoiding a 'powerful voice use'.

Good voice technique Develop an efficient voice that is as little as possible inconvenient for the vocal cords. Such as the use of a soft speaking voice on a good pitch (many people speak too low). When singing emphasis on register overweight (breast-falsetto) and not only increase of frequency or tonal focus.

Optimal medical treatment for gastric acid reflux and allergy

Speech therapy / singing therapy Sometimes active adapted voice / singing therapy is recommended with a variable duration ranging from a few weeks to 6 months.