Although different methods of communication have emerged with modern life, I still think that our most important communication tool is our voice.
Whether we are a child or a young individual, or in an active working life. No matter how we become adults, our need for our voice never decreases at any time in our lives. We feel the need to use our voice effectively when conveying our needs, wishes, feelings and thoughts to others. If people working in some professions did not have a voice, they would be deprived of doing a significant part of their job as they wish. This group, called "audio professionals", actually includes many more professions than expected. If we list them from the first ones that come to our mind, teachers, lawyers, doctors, voice and stage artists, call-center employees, bank employees, faculty members, shop assistants, television and radio programmers, religious officials, marketers and many other professions are included in this group.
How can voice disorders be prevented?
Voice disorders can be prevented before they occur, thanks to voice hygiene and voice therapy programs specially prepared for the individual's voice needs. Hygiene and therapy methods to be applied in case of any voice disorder will contribute significantly to the earlier and more successful treatment.
What is the cause of voice disorder, voice disorder, voice disease, hoarseness?
As in other organs of our body, many different reasons can cause similar symptoms. For example, hoarseness may be the first symptom of more manageable causes such as a short-term cold, allergies or reflux, or serious problems such as vocal fold paralysis or vocal fold cancer.
Voice. How to make a correct diagnosis of voice diseases?
Correct diagnosis of voice diseases can be achieved by using objective (subjective) and subjective approaches together. The condition of the individual's voice is evaluated according to the perception of both the individual and the relevant clinician. When necessary, standardized sound recordings are taken, and a direction called acoustic analysis is performed on these recordings. Comparable numerical data are obtained. In addition to a complete ear, nose, throat and head and neck examination of the patient, a whole body examination is performed when necessary. Both rigid and flexible telescopes can be used to visualize the vocal folds and other related structures. Since the vocal folds vibrate an average of 100-140 times per second in adult males and 200-240 times in females during vocalization, special instruments are needed to see these structures. The light technology that provides this is called stroboscopy. Voice examination performed under a stroboscopic light source (videolaryngostroboscopy) is the gold standard for diagnosis. In this way, a lot of information that cannot be obtained with simple examination methods can be obtained and a correct diagnosis can be made.
What are the diseases that most commonly cause voice diseases?
Voice diseases are organic. and functional causes. Organic causes are disorders such as nodules, polyps, cysts, grooves (sulcus), white and red spots in the vocal folds, granuloma, reflux, paralysis, and cancer, which we can list as some examples. Functional causes refer to situations in which no visual problem is detected in the vocal folds and ear, nose and throat examination, but a problem is detected in the individual's use of the relevant structures.
How are voice diseases treated?
Treatment for voice diseases is determined according to the cause of the disorder. Voice therapy, medical (drug) treatment and surgical treatment are the three main treatment methods.
What is voice therapy?
Voice therapy is a method that can be used for all voice problems. It is a treatment method. While it is used as the sole treatment method for some voice disorders, in others it can be used as a supporter before and after medical or surgical treatment. Although very useful, there is no specific voice therapy method for any voice pathology. On the contrary, the voice therapy method, intensity and duration chosen for each patient should differ from each other according to the patient's needs. Ideally, the cause of the patient's voice problem should be determined before starting voice therapy. For this purpose, objective voice analysis should be performed and vocal cords should be evaluated with videolaryngostroboscopy. It is necessary to measure it.
The findings obtained should be evaluated with the patient and the team that will play an active role in voice therapy, and if the patient is a voice professional, with other people interested in his/her voice, and therapy goals should be determined.
In recent years. The increase in knowledge about the larynx (larynx, larynx) has also increased interest in the physiology, disorders and treatment of voice and voice disorders. In this way, significant progress has been made in the objective evaluation of the voice and imaging of the vocal cords. Thus, much faster and more accurate diagnoses can be obtained and the treatment process can be started as soon as possible. Since the time constraints of both health professionals dealing with voice disorders and voice professionals who make a living with their voices increase day by day, today's voice therapy protocols are planned as approximately 6-10 sessions. Although the goals of each voice therapy method are different, there are some general goals that are universal to all voice therapy techniques. These are important both for voice therapies given before or after surgery, or for voice therapy to be used as a single treatment:
Patient education:Patient education is the first priority for all treatment protocols. It is a step. Every patient should be aware of how the voice is formed and what kind of distress their problem causes in their voice. The patient must understand the rationale for voice therapy, the technique to be used, and the goals of the treatment. If the treatment approach does not agree with the patient, or if the person who will apply the therapy is not determined or does not provide sufficient explanation, it will be difficult for the patient to comply with the treatment program.
Voice hygiene:In general, the voice hygiene rules that should be applied In addition, specific attention should be paid to each patient and the issues that should be done/don't be done accordingly should be determined. For example, it is important for all voice users to drink enough fluids and, if necessary, to humidify the environment. Having information about personal sound usage habits, knowing the environment where sound is used intensively and the noise characteristics in the environment, and examining other environmental factors will enable the acquisition of healthier sound habits. ir. Not smoking, reducing general stress, and knowing the medications used and their effects on body fluids are also important requirements.
Correction of excessive voice use:Ensuring that individuals with hoarseness speak in lower voices, It is important to prevent loud talking and avoid habitual or frequently repeated throat clearing. Total use of sound throughout the day should be reduced. Laughing loudly, crying and coughing are also behaviors that damage the voice. All these rules can be used for individuals with voice problems, except for patients with neurological or hypofunctional hoarseness.
Agreed goals and expectations:The individual with the voice problem and the person who will provide voice therapy. The person must 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.
The patient should be able to notice changes in his voice:If the patient, If the person cannot notice or feel the changes in his/her voice caused by voice therapy, voice therapy cannot be beneficial. This is a situation that we do not encounter frequently in voice professionals, but we encounter frequently, especially in the elderly population and individuals with neurological problems.
Is it possible to treat voice disease with voice therapy alone?
Yes, some voice diseases can only be treated with voice therapy methods. Among these, functional voice disorders, voice problems due to some neurological and psychiatric diseases, and most vocal fold nodules can be given as examples.
Are surgical methods successful in the treatment of voice diseases?
Yes, surgical methods can be up to 100% successful in the treatment of many voice diseases. These include many different causes such as vocal fold polyps, vocal fold cysts, granuloma, papilloma and cancer.
What is the role of medical/drug treatment in the treatment of voice diseases?
Primarily laryngitis (infection and inflammation of different parts of the vocal folds and larynx) and laryngopharyngeal reflux It is possible to obtain successful results with drug treatment in many different voice diseases, including � (retroflow of stomach contents to the level of the vocal folds).
Who should a person with voice disease or voice-related problems contact?
An individual with a voice problem should consult an Ear, Nose and Throat specialist who specializes in voice diseases.
I wish you a healthy voice.
- 332 male, 28 female patients
- Age range 18-78 (average 48)
- Symptoms: Hoarseness 91%, foreign body sensation 9%; Duration: 1-36 months It was applied until it disappeared.
- 339 patients were treated with surgery; Submucosal cordectomy was performed for leukokeratosis located opposite the main lesion, mucosal slicing and scanning for leukokeratosis associated with type II and III sulci, and partial subligamental or transmuscular cordectomy was performed for leukokeratosis without a known cause. Follow-up was done every month in the first year and every two months in the second year.
Lesions were divided into 4 groups according to their history, video images and microscopic morphology:
Type I – inflammatory leukoplakia ( #21, 6%): Bilateral, white membrane-like appearance, 2 weeks to 2 months history; URI, excessive cough, excessive alcohol use, excessive use of the voice, sudden onset and with significant hoarseness. Symptoms improve significantly with approximately 2 months of conservative treatment.
Type II – frictional polyp (#76, 21%): Characterized by unilateral, limited, local mucosal thickening in the cord opposite the polyp.
Type IV – simple leukokeratosis (#195, 54%): May be limited to the mucosa or extend into the submucosa. . It may be patchy, verrucous or papillary. It may be limited or involve the entire cord.
All cases with type I lesions last for 2 months.
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