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Health Information Keep Expressing Yourself: Don't Lose Your Voice

Talking on the phone, singing in the shower, reading bedtime stories to your kids, heckling umpires at a White Sox' game. Every day, in countless ways, you rely on your voice to help you express yourself.

But when you have problems with your vocal cords or the muscles of the jaw, you may find yourself speechless — literally.

There are many types of voice disorders, including polyps, cysts, nodules or sores on the vocal cords; chronic laryngitis; vocal cord paralysis; and inability to control the jaw muscles, caused by dystonias, or neurological movement disorders. They can cause symptoms ranging from hoarseness to bleeding to complete blockage of the airway. While most voice disorders are benign, some can be life-threatening, such as paralysis of both vocal cords, which impairs breathing, or cancerous growths on the vocal cords.

Under the direction of Steven Charous, MD, the voice disorders program at Rush University Medical Center specializes in the diagnosis and treatment of common and complex voice problems, combining the expertise of physicians, speech pathologists and voice therapists. The program even offers singing coaches to help professional songbirds fine-tune their voices.

The comprehensive approach to voice disorders at Rush starts with an in-depth analysis of the problem. After a diagnosis is made, Charous and his team work collaboratively to devise and implement an effective treatment plan.

Depending on the type and severity of the problem, that plan may include surgery, injections, medications and speech therapy. Dystonias and vocal cord spasms are often treated using injections of botulinum toxin or Botox — yes, the same substance plastic surgeons use for cosmetic purposes — which works by preventing nerves from communicating with the muscles they serve.

When the vocal cord muscles become atrophied due to old age, causing a decrease in vocal clarity, volume and pitch, speech therapy may help. If not, Charous says, surgical procedures involving injections or implants of collagen, fat or fascia, a fibrous tissue that can be taken from under the skin, may be used to "bulk up" the cords and restore vocal strength and clarity.

Surgery — using a laser or scalpel — may be the best option for vocal cord paralysis; to remove lesions, nodules, polyps or cysts; or for very severe dystonias. Charous has expertise in both microsurgery (surgery done under the high magnification of a microscope) and endoscopy (surgery using a special viewing instrument that allows a surgeon to see inside the body through very small incisions). These techniques enable him to better visualize problems and to minimize trauma to muscles and tissues.

"Because we use a team approach at Rush, we can address all the various aspects of voice disorders," Charous says. "We have the experience to know which treatment or combination of treatments will give patients the best possible results."

So you'll be back to crooning into your showerhead before you know it.


Don't Take Your Voice For Granted
You don't have to be a professional singer to suffer from a voice disorder. Even simple things, like smoking or yelling a lot can eventually take their toll on your vocal cords, leading to problems that require treatment. The good news is that there are some simple things you can do to protect your voice, including:

* Avoid smoking and excessive alcohol intake.
* Drink six to eight glasses of water a day to keep your vocal cords well lubricated.
* Avoid caffeine, which tends to dry the throat and thicken secretions; it can also increase reflux of stomach acid into the throat and cause irritation.
* Rest your body and voice periodically.
* Speak in your natural tone and pitch.
* Avoid clearing your throat, excessive coughing and whispering (whispering can put more strain on your voice than speaking normally).
* Avoid excessive yelling or screaming, such as at sporting events, concerts or clubs.
* See your doctor if you experience hoarseness for more than one week without improvement or for more than two weeks total. If hoarseness is associated with shortness of breath or difficulty swallowing, see your doctor immediately.

Recognizing a problem early can often decrease the severity of a disease process and lessen the severity of the treatment, so if you are having problems with your voice or pain or discomfort in your throat, don't hesitate to see your doctor.


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