VOCAL OVERDOERS AND BENIGN MUCOSAL DISORDERS
WHAT ARE THE RISK FACTORS?
Individuals who like to speak naturally and use loud voice.
HOW ABOUT THE EXAMINATION?
The voice organ and its function are examined by an ENT doctor and a speech therapist. The voice has 3 functions: breathing, protecting the airway while swallowing and speaking. Every person is dependent on these 3 functions every moment of the day.
In addition to a thorough survey and a clinical examination of the neck, an inspection of the vocal cords (laryngoscopy) takes place at rest and during vocalization. This is supplemented by a stroboscopy, research in which through short flashes of light, the vibration pattern of the vocal cords is delayed and thus displayed in more detail.
Then, the voice and voice capacity is listened to. One can often hear the nature of the voice problem while speaking. Sliding, softer or louder voices, soft singing can help to find the right cause of the weak or painful voice.
In addition, a voice examination usually takes place, including aerodynamic parameters (the maximum phonation time), acoustically perceptual parameters (e.g. habitual speech pitch, voice quality in function of the change intensity and pitch) and the vocal range (intensity and frequency dynamics).
If the cause or complete diagnosis is not yet clear, additional studies may be appropriate. Percutaneous electromyography (E.M.G.) can provide additional information about muscle activity and innervation of laryngeal muscles. Radiological examinations (e.g. RX of the lungs or CT neck) can demonstrate a local cause of vocal cord paralysis.
WHAT ARE VOCAL OVERDOERS?
The following information is for patients with problems affecting the surface covering of the vocal folds. Benign mucosal disorders almost uniformly appear in vocal overdoers. Common names for mucosal disorders includes vocal nodules, vocal polyps, vocal cysts. If you have been told you have vocal hyperfunction or plicae ventricularis and yet the following does not seem to apply to you, please read about vocal underdoers.
WHAT ARE THE CAUSES?
Overusage is probably the most common factor causing injury to the surface covering of the vocal folds. On a self-rating scale of talkativeness, almost everyone with a benign mucosal injury rates themselves as a 5, 6, or 7, which means they innately enjoy talking. They are vocal overdoers. (This usually causes a swelling on both vocal cords in the form of nodules, but at times polyps form in the same way). While quantity is the primary driving factor, volume is clearly a secondary factor. The louder one uses the voice, the more trauma occurs on the lining of the vocal cords. Technique may play a role. There are ways of holding the vocal cords further apart that seems to allow for more traumatic collisions during vibration of the vocal cords.
One-off voice abuse - It is possible not to be a chronic vocal overdoer and yet injure the surface lining with one poorly timed vocal misuse such as a loud scream at sports event. (This usually causes a hemorrhage, a hemorrhagic polyp, or in the long term, a regular polyp on one vocal cord).
Cyst formation: a mucous gland may become plugged and form a cyst by trapping a pocket of material under the surface of the vocal fold. If present from birth this would be a congenital cyst. If this ruptures, an infolding of the surface may result called a sulcus. This type of mucosal disorder is not from overuse.
Teleangiectatic vocal cord polyp
Vocal cord noduli
Vocal cord cyst
In the event of overuse of the voice or mucosal disorders, it is first and foremost often advisable to check your voice use. The majority of the 'overdoers' have a hard time talking quietly. Some may consciously reduce their speech to a 4 (an average speaker), which often seems as if you are almost completely silent. What often helps is to ask the people around you feedback about your use of your voice and to check whether it matches your own perception. Most 'overdoers' are often all-or-nothing speakers and find it easier to check when they are completely silent and when they can talk, such as, for example, a networking event or singing performance. So you stay a 6 or 7 when you communicate with others but you schedule rest time to reduce your total daily speech activity. In addition, two swelling tests ('soft singing test' and 'staccato test') have been developed in which you can check the swelling of your vocal cords yourself (without endoscope). This way you can determine the causes of the swelling yourself and determine when your vocal cords need more or less rest.
In addition to self-discipline, a speech therapy treatment can also 'overdoers' help to adjust their speech habits. The speech therapist will examine, support and train you speech, singing technique and / or breathing technique.