The Professional Voice

People who use their voice professionally may experience voice disorders manifesting as hoarseness or breathiness, lowered vocal pitch, vocal fatigue, nonproductive cough, persistent throat clearing, and/or throat ache. These symptoms often have benign causes, such as vocal nodules, vocal fold edema, polyps, or granulomas. Such disorders are often caused by voice-use injuries and may be worsened by other conditions such as laryngopharyngeal reflux.

Treatment in most cases includes the following:

• Voice evaluation by a speech pathologist or experienced physician, including, when available, use of a computer-assisted program to assess pitch and intensity and to determine parameters of vocal acoustics

• Behavioral treatment (decreasing musculoskeletal laryngeal tension when speaking) using a computer program for visual and auditory biofeedback

• A vocal hygiene program to eliminate vocally abusive behaviors, such as excessive loudness, long duration (continuous speech for > 1 hour), vocal tension (excessive muscular strain during phonation), and habitual throat clearing

• An antireflux regimen, when appropriate

• Adequate hydration to promote an adequate glottal mucosal wave