Voice Disorders, part II

View part I.

World Voice Day is approaching on April 16th, and we continue our posts about voice disorders.  If you have any questions or comments, please feel free to leave them below.  The voice is an amazing instrument.  How is yours working for you?   

Normal human vocal cords (or vocal folds) consist of two infoldings of tissue situated horizontally across the larynx, or voice box, at the top of the windpipe. Vibrations, caused by air from the lungs moving past adducted vocal cords, produce the sound of the voice. The sound of each individual voice is determined by the size and shape of a person’s vocal cords, throat, nose and mouth, as well as environmental, behavioral, emotional, psychological and other physiological factors.

Voice disorders range widely in their vocal impairment, severity, causes and treatments. Nerve damage, acid reflux, smoking, an over- or under-active thyroid, stress and a person’s psychiatric and physical health can all create or worsen a voice disorder. Some voice disorders are caused simply by vocal misuse, like speaking or singing with poor technique, and overuse, such as excessive singing, talking, coughing or yelling.

Some common disorders appear below. See a laryngologist if you experience vocal discomfort or unexplained loss of voice that lasts longer than two weeks.
 
Laryngopharyngeal Reflux–inflammation of the larynx caused by gastric acid.
Symptoms: Decreased vocal performance, increased effort upon voicing;  may or may not include “heartburn” or indigestion.   Lifestyle changes are recommended, such as avoiding spicy and acidic foods, especially late in the day.  Medications that decrease acid production or level are a common treatment.
Causes: Reflux, specifically a back flow of stomach contents through the esophagus which spills over into the larynx and pharynx (i.e. throat)  that results in swelling and irritation of the laryngeal and pharyngeal tissue.

Vocal Fold Bowing–a small gap in the middle of the vocal folds develops and causes incomplete vocal fold closure, commonly seen in older adults. May improve through strength and flexibility exercises.
Symptoms: Less than optimal voice, weakness, breathiness, hoarseness, or a strained voice.  Treatment options include voice therapy to strengthen the voice and injections into the vocal folds to “bulk them up”. 
Causes: Age and atrophy of the larynx, inactivity of the vocal folds.

Vocal Fold Cyst–a fluid-filled lesion that can occur at any location on the vocal folds, and which interferes with vibration and fold closure at times. Usually appears on one side, but may cause swelling on the opposite side due to irritation.
Two types of cysts: 1. Mucus retention cysts occur when a glandular duct is blocked and unable to secrete; 2. Epidermoid cysts result from congenital defects or trauma.
Symptoms: diplophonia, a voice quality in which the vocal cords produce multiple tones at the same time; dysphonia an impaired quality of voice typically involving hoarseness or a breathy sound. Treatment involves voice therapy and medical interventions including surgery if necessary.
Causes: An upper-respiratory infection combined with vocal overuse, or trauma, which makes tissue prone to developing cysts. Females are more likely than males to be effected.

Spasmodic Dysphonia–inovoluntary movement of the vocal folds during speech resulting in irregular voice breaks and interruptions of phonation (sound). Most common in females between the ages of 20 and 50.
Depending on type of SD, the vocal folds may slam together and stiffen cutting off words or making it difficult to start; or spasms can cause the vocal folds to open allowing air to escape from the lungs during speech. A mix of these types may also be present.  Injecting Botox into the spasming laryngeal muscles causes temporary paralysis of those muscles and usually results in improved voice.
Symptoms: Tight/strained voice; choppy voice similar to stuttering; strained or strangled and full of effort; weak, quiet and breathy or whispery voice. Spasms are usually absent during activities such as laughing or singing.
Causes: Believed to be neurologic in nature with stress and other environmental factors exacerbating symptoms.

Muscle Tension Dysphonia–(sometimes referred to as muscle misuse dysphonia or vocal hyperfunction) a cluster of abnormal patterns of vocal muscle activation, most commonly excessive or unequal muscle tension due to inappropriate use while speaking or singing. Ranges from mild to severe.
Symptoms: In severe cases, voice is extremely breathy or tight/strangled and high-pitched. Treatment involves abdominal-diaphragmatic breathing, relaxation, muscle control, and voice placement exercises guided by a speech pathologist.
Causes: Theories point to incomplete relaxation of the muscle responsible for opening the vocal folds, excessive contraction of certain muscle groups, and incoordination of laryngeal muscle contraction with air pressure and airflow timing. 

View part I.

Posted on 13 April 2009 | Category: General, Voice

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Accent Modification – A Racist Goal?

One of the services we provide at The Sound Center is accent modification for foreign and regional accents.  Clients work on pronunciation, intonation, speaking rate, style of presentation, and tone of voice, among other areas.  The accent we teach is American English, as spoken by most broadcasters in the US.

Some see this work as fundamentally racist.  They claim that the group in power dictates the correct way of speaking, and the less powerful are forced to change.  Who has the right to say which way of speaking is correct?

I can see their point, especially when people are dismissed or demeaned for the way they speak.  However, in my opinion, communication is the goal.  If people have ideas to share but their audience cannot understand them, it is to their benefit to make some changes in the way they speak.

I have simplified this debate considerably, but I am curious to find out what you think.  Is accent modification a racist goal?

Posted on 10 March 2009 | Category: Accent, Communication, Presentation, Voice

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