UNIT 7 – VOCAL HEALTH

Excessively Loud Voice

May be associated with other unfavorable conditions, Correlation between increased loudness/increased vocal fatigue, Hard glottal attacks initiating voice, Too much vocal adduction leads 2 vocal fold medial edge irritation and arytenoids are closed forcefully; laryngeal structures swell.

Allergy Or Upper Respiratory Infection (URI)

Overreaction of immune system to substance; Seasonal voice changes; Upper respiratory infections; Inflamed larynx more vulnerable to effects of phonotrauma; Excessive talking intensifies/cause additional voice issues

Frequent Coughing & Throat Clearing

Forceful/abrupt closure of vocal folds; May cause tissue irritation over time; May be modified as part of voice therapy program; Full evaluation may be needed to rule out other factors; Common causes are URI, asthma, gastroesophageal reflux (GERD/LPR)

Smoking & Exposure To Smoke

Significant health hazard; lowers vocal pitch, like women (Reinke's edema); Reduces oxygen supply to tissues; faster aging process; inflammation of larynx tissues, due to decreased action of cilia in respiratory tract; Second hand smoke carries 40% of primary smoking effects

E-Cigarettes

National Academies of Science, Engineering and Medicine, January 2018: causes health risks; contain a number of potentially toxic substances; Moderate evidence that youth who use are at increased risk for cough and increase in asthma exacerbations

Alcohol Intake

Excessive drinking may cause tissue damage; When combined with smoking and excessively loud speech; alcohol may be especially damaging; Negatively affects hydration levels and vocal behaviors

Marijuana Use

One of the most commonly abused substances; 54% of people between 25-34 have used marijuana once; Common phonotrauma symptoms include daily cough and phlegm

Chewing Tobacco

Increased risk of oral cancers; Primarily seen in young males

Caffeine Intake

Caffeine is a diuretic, may lead to dehydration; Caffeine is an addictivecsubstance; Decrease amount of intake

Poor Nutrition

Lack of nutrition can affect a person's ability to fight infection and handle stress

Dehydration/Inadequate Fluid Intake

recommendation is eight 8-oz glasses of water every day; Increasing hydration helps combat other phonotraumatic behaviors; Increases efficiency of vocal fold vibration/reduce vocal fold swelling; Brain works more optimally when hydrated

Medications

Antidepressants, Muscle relaxants, Diuretics, Antihypertensives, Antihistamines, Asthma medications - inhaled steroids, High-dose Vitamin C, ACE inhibitors, Oral contraceptives

Obesity

May interfere with breath support for voice production; May affect endurance; May cause fatigue; May exacerbate gastroesophageal reflux which is a common cause of vocal pathology

Sleep Deprivation

Normal sleep requirements vary from 6-10 hours; General body fatigue is reflected in the voice; Performers are especially susceptible

Strain Resulting From Talking While Engaging In Sports And Exercise

Over adduction of the vocal folds may occur when an athlete grunts or talks during strenuous exercise

Abusive Singing Habits

Maintaining singing levels that exceed the vocal capabilities; Singing at upper and lower limits of the singer's range of voice; Poor postural habits during singing

Warm Up Signing Habits (positive)

increases blood flow to the vocal folds structure; Two octave pitch glides on /i/ or /u/ and lip/tongue trills

Symptoms Of Esophageal Dysfunction/Disease

Dysphagia, Odynophagia, Heartburn or pyrosis, Regurgitation, Non-heartburn chest pain, Water brash, Bleeding, Excessive mucous, Belching, Respiratory symptoms, Laryngeal symptoms

Clinical Interview/Chart Review

History of symptoms onset, Progression, Timing of symptoms, Self-compensation, Weight, Medications, Family history, Diet

Reduce Phonotrauma

Phonotrauma and associated problems are best treated Behaviorally; Reduction in phonotraumatic behaviors are associated with reduction in laryngeal pathology; The Speech-Language Pathologist designs a program of behavior change