Voice Therapy -Procedures, Side effects, Recovery time, Costs and alternatives

The objective of voice therapy is to either improve or get rid of the problems associated with the ‎vocal sound creation in the larynx of an individual.‎After the voice therapy gets completed the ‎voice is expected to sound like before as it used to and be stronger. In the voice therapy there are ‎several exercising techniques which have been tailored to solve all the problems associated with ‎voice. For the majority of the vocal disorders, voice therapy is the best and most suitable option ‎for treatment. The voice of an individual may sound rough and harsh; it might also sound like ‎husky or strained. An example for a person suffering from a voice disorder can be if an ‎individual is not able to hold a key as it was done by that individual previously. Another instance ‎of a voice disorder is a singer not being able to sing songs having low or high notes. It has also ‎been observed that the voice of the person may vanish in some cases.‎

There are different types of voice disorders which require treatment through voice therapy. The ‎disorders of the voice are grouped as follows Organic voice disorder: this is a type of disorder which is caused when the larynx is affected by ‎the change. The physical changes observed in the voice may also result from a functional ‎disorder. The vocal cords of an individual getting paralyze after undergoing thyroid surgery ‎come under organic voice therapy.‎

Psychogenic voice disorder: in this type of disorder the voice may become hoarse. After the ‎occurrence of a distressing event, an individual may completely lose his/her voice.‎ Functional voice disorder: this kind of disorder arises in people that have a habit of speaking ‎loudly and frequently. Some people might speak in a register which is not suitable for them.‎ Thus, it would not be wrong to say that voice therapy involves changing the biomechanics of the ‎production of voice.‎

There are numerous voice therapy techniques that are available and which can be applied for the ‎treatment of the voice disorder. However, the approach taken for voice therapy varies for distinct ‎individuals. There is no specific voice therapy treatment that can be given to all the patients. ‎Before starting the treatment with any of voice therapy techniques it is essential that a voice ‎therapist first assess the symptoms being exhibited by a patient and then decide which single or ‎combination of techniques would be best suited for the treatment.‎

Some of the voice therapy approaches which are applied for treatment are given below

Symptomatic voice therapy: in this methodology of the voice therapy the symptoms which are ‎causing the voice disorders are either directly or indirectly modified. This therapy modifies the ‎loudness, rate, laryngeal muscle tension, resonance, phonation, and respiration. One of the most ‎widely used techniques in symptomatic voice treatment methodology is chant-talk technique. ‎This therapy is useful in the reduction of the phonatory effect. The objective of this technique to ‎decrease the effort required for talking. Initially, a patient is made to hear a few recordings and is ‎then told to imitate them in different patterns of voice. Another technique belonging to the ‎symptomatic voice therapy treatment is resonant voice therapy. This technique is often taught to ‎the singers and actors for enhancing their production of voice. In this technique, the force of the ‎vibration of vocal cords against each other is reduced.‎

Physiologic voice therapy: a treatment thought this methodology is adopted when the vocal ‎mechanism is disturbed by a voice disorder. In this therapy, the physiologic activities are ‎modified that are having an effect on the resonance, phonation, and respiration. The objective of ‎this therapy is to strike a balance among several subsystems. The most common technique used ‎for voice therapy in this methodology is accent method. This technique finds its use in the ‎treatment of dysphonia, dysprosody, and stuttering. The main objectives of this technique are a ‎reduction of the glottis waste, increasing the pulmonary output, stabilizing the vibration pattern, ‎and reduction in the muscle tension. This procedure is divided into two parts which are ‎diaphragmatic breathing and rhythmic vowel play.‎ If a patient has undergone laryngectomy for the treatment of some disorder then voice prosthesis ‎is used to help the patient in speaking. In such a patient voice therapy is used for regaining the ‎ability to speak.‎

Any individual that is suffering from the disorder of the voice is eligible for the treatment using ‎voice therapy. A patient suffering from the following problems associated with the voice is ‎eligible for treatment

• Neurological disorders
• Viruses
• Bacterial infections
• Allergies
• Surgery of the vocal fold
• Misusing the voice like raising the voice and screaming.‎

A patient suffering from the laryngitis is eligible for the treatment as it can lead to loss of voice ‎quality. A patient suffering from the swelling of the vocal cords is a candidate for the treatment. ‎A patient suffering from a neuromuscular disorder like strokes, Parkinson’s disease, and laryngeal ‎cancer is an eligible candidate for treatment as these disorders affect the voice quality.‎

Whether a person is eligible for treatment through voice therapy or not is decided by the doctor ‎based on the voice quality and the condition a patient is suffering from. A patient having a ‎problem of sore throat is not an eligible candidate for treatment with voice therapy as this ‎condition usually goes away after some time. A person who is not suffering from any voice ‎disorders is not eligible for treatment with voice therapy.‎

Any treatment involving medicines, surgeries, and injectable have some or the other side effect ‎associated with them. The side effects range from being mild to severe. The occurrence of a mild ‎or a severe side effect varies from patient to patient. A patient experiencing a mild side effect ‎does not need to worry as they usually go away after a brief period of time. However, in case a ‎serious side effect is experienced then the doctor must be informed promptly by the patient. ‎

A patient undergoing treatment using voice therapy does not experience any potential side ‎effects of the treatment. Since the treatment through voice therapy involves exercises of the ‎vocal muscles hence no side effect is observed. However, in the initial stages of the therapy, a ‎patient may experience some pain and difficulty.

• The exercises related to the relaxation of the muscle tension of the vocal cords must be ‎continued and not abruptly ended.‎
• The breathing exercise for coordinating the breathing while speaking must be continued.‎
• The phono-traumatic behaviors like screaming, yelling, excessive crying, throat clearing, ‎and raising voice must be avoided.‎
• The upper respiratory tract must be humidified with increased intake of water.‎
• Drinks like alcohol and caffeine must be completely eliminated.‎

In the majority of the patients that have been advised treatment with voice therapy, the voice ‎grows stronger only after two to three weeks of therapy. During this duration, a doctor may ‎examine the vocal cords to check whether a recovery has started or not. A complete recovery of a ‎patient depends upon the condition for which the voice therapy treatment is being undertaken. In ‎minor cases may only take a couple of weeks while in a severe condition it may take months to ‎completely recover from the voice disorder.‎

The cost of voice therapy in India varies for different cities. In small cities, the fees of the voice ‎therapist range from 300 to 700 rupees per session based on the experience of the therapist. In ‎metro cities, the fees of voice therapist range from 1000 to 2000 rupees per based on the ‎experience of the voice therapist.‎

In the majority of the cases the results of the treatment of voice therapy are permanent. But as ‎they say future is uncertain thus there is always a possibility that a voice disorder may reoccur in ‎the future unless prevented by some effective post-treatment measures.‎

The alternatives to the treatment of voice therapy include the surgical procedure of the vocal ‎cords or use of a vocal prosthesis. The surgical procedures may include cricothyroid ‎approximation, laryngoplasty, and laser-assisted voice adjustment. In the voice prosthesis, an ‎artificial device made of silicon helps the patient in speaking. However, these techniques are only ‎useful if they are used in conjunction with voice therapy. ‎