Voice Therapy

What is Voice Therapy?

Voice therapy is a treatment method that can be used for all voice problems. It can be used as a stand-alone treatment for some voice disorders, while for others it can be used as a supportive treatment before and after medical (medication) or surgical intervention. Although very useful, there is no specific voice therapy method for any voice pathology. Rather, the method, intensity and duration of voice therapy chosen for each patient should differ according to the patient's needs.

Identifying the cause of hoarseness

Ideally, the cause of the patient's voice problem should be identified before starting voice therapy. For this purpose, objective voice analysis and evaluation of the vocal cords using videolaryngostroboscopy is necessary. The findings obtained should be evaluated in collaboration with the patient and the team that will actively participate in voice therapy (Ear, Nose, and Throat Specialist and Voice Pathologist) and, if the patient is a voice professional, with others concerned with the voice (such as Voice Coach, Singing Instructor), and therapy goals should be determined.

Objective and Subjective Assessment in Voice Disorders

In recent years, the sudden increase in knowledge about the larynx (voice box) has also increased interest in the physiology, disorders, and treatment of voice and voice disorders. Consequently, significant advancements have been made in the objective assessment of voice and visualization of the vocal cords. Thus, faster and more accurate diagnoses are obtained, and treatment can commence as soon as possible. With each passing day, both the time constraints of healthcare professionals dealing with voice disorders and those of voice professionals making a living through their voice are increasing, leading to current voice therapy protocols being planned for about 6-10 sessions.

Goals of Voice Therapy

Although the objectives of each voice therapy method differ, there are some universal general goals applicable to all voice therapy techniques. These are important for both surgeries before or after and for voice therapy used as the sole treatment:

1. Patient education: Patient education is the first step in all treatment protocols. Each patient needs to understand how voice is produced and what issues their problem causes in their voice. The patient must understand the logic of voice therapy, the technique to be used, and the goals of the treatment. If the treatment approach does not make sense to the patient, or if the person administering the therapy is not determined or fails to provide adequate explanation, the patient's compliance with the treatment program will be difficult.
2. Voice hygiene: In addition to the voice hygiene rules that should be applied to each patient, specific considerations must be identified for each patient regarding what should or should not be done accordingly. For example, sufficient fluid intake is important for all voice users, as well as humidifying the environment if necessary. Being knowledgeable about personal voice usage habits, understanding the noise characteristics of the environment, and examining other environmental factors will help acquire healthier voice habits. It is also essential to avoid smoking, reduce overall stress, and understand the effects of medications on body fluids.
3. Correcting excessive voice use behavior:  It is very important to encourage individuals with hoarseness to speak more softly, to avoid speaking loudly and to discourage habitual or frequent throat-clearing behaviors. The overall use of the voice throughout the day should be reduced. Laughing, crying and loud coughing are also voice-damaging behaviors. All of these guidelines can be applied to individuals with voice problems, except for patients with neurological causes or hypofunctional hoarseness.
4. Agreed goals and expectations:  The individual with voice problems and the voice therapy practitioner should agree that there is a problem with the voice, that something needs to be done about it, the path to be followed and the intended goals.
5. Being aware of the changes in the patient's voice:  Voice therapy will not be beneficial if the patient is unable to recognize or feel the changes that voice therapy has caused in their voice. This is not common in voice professionals, but it is especially common in the elderly population and in individuals with neurological problems.