Voice Therapy-Puberphonia,Aphonia,Diplophonia,Dysponia

What is a voice disorder?

A voice disorder can be defined as a problem when the pitch, loudness or quality of the voice calls attention to itself rather than to what the speaker is saying. A voice disorder is an abnormal change in the way a person’s voice sounds. It is also a problem if the speaker experiences pain or discomfort when speaking or singing.

• Laryngitis: This is when your vocal cords swell. It makes the voice sound hoarse. Or you may not be able to speak at all. Acute laryngitis happens suddenly. It is often caused by a virus in the upper respiratory tract. It often lasts just a few weeks. Treatment is to rest the voice and drink plenty of fluids. Chronic laryngitis is when the swelling lasts for a long time. Common causes include a chronic cough, using inhalers for asthma, and GERD (gastroesophageal reflux disease). Treatment of chronic laryngitis depends on the cause.
• Vocal cord paresis or paralysis:The vocal cords can be paralyzed or partly paralyzed (paresis). This can be caused by a viral infection that affects your vocal cord nerves, an injury to a nerve during surgery, stroke, or cancer. If one or both of your vocal cords are paralyzed in a nearly closed position, you may have noisy or difficult breathing. If they are paralyzed in an open position, you may have a weak, breathy voice. Some people will get better over time. In other cases, the paralysis is permanent. Surgery and voice therapy may help improve the voice.
• Spasmodic dysphonia: This is a nerve problem that causes the vocal cords to spasm. It can make the voice sound tight, quivery, jerky, hoarse, or groaning. At times, the voice may sound normal. Other times, the person may not be able to speak. Treatment may include speech therapy and shots (injections) of botulinum toxin to the vocal cords.
• Puberphonia: Puberphonia (also known as mutational falsetto, functional falsetto, incomplete mutation, adolescent falsetto, or pubescent falsetto) is a functional voice disorder that is characterized by the habitual use of a high-pitched voice after puberty, hence why many refer to the disorder as resulting in a 'falsetto' voice.
• Androphonia: Androphonia characterized by abnormally low pitched voice less than 100Hz presenting as male voice in females The pitch can be raised to female level by voice feminizing surgery and voice rehabilitation

Symptoms of Voice

• Hoarseness
• Breathiness
• Pitch change
• Voice “cracks”
• Loss of vocal range when singing
• Frequent throat clearing
• Vocal fatigue/pain
• Strain/effortful voicing
• Voice loss (aphonia)
• Tremor

DIAGNOSTIC PROCESS

At Sanwal Rehabilitation House, we follow the below mentioned Procedure:

• Case History
• Voice Severity Rating Scale
• VOICE HANDICAP INDEX (VHI)
• GIRABAS Voice Rating Scale
• VAGHMI
• Dr.Speech

VOICE THERAPY

Voice Therapy consists of two main parts, Vocal hygiene and exercises, to change the biomechanics of voice production. Vocal hygiene is similar to dental hygiene, a daily program to keep the voice functioning at its highest level. Maintaining good nutrition and hydration is a key to vocal hygiene. Avoiding vocal abuse such as shouting, smoking, excessive alcohol intake and noxious chemicals are all part of vocal hygiene. Voice therapy is a behavioral program to adjust the biomechanical forces that produce the sound of the voice. Exercises include breathing techniques, vocalizing exercises, proper placement of the vocal structures and adjustment of force or effort at the oset of the voice. Since hoarseness may evolve from various diagnoses, the type of therapy to use is determined by the diagnosis.