From the Guidelines
Managing a change in voice requires a comprehensive approach that prioritizes identifying the underlying cause and providing symptom management, with a strong emphasis on voice therapy and lifestyle modifications to improve vocal health and reduce the risk of further complications, as recommended by the most recent guidelines 1. The approach to managing a change in voice should involve a thorough medical evaluation to determine the cause, which could range from vocal strain, infection, nodules, polyps, to more serious conditions like cancer.
Key Components of Management
- Resting the voice by limiting speaking and avoiding whispering
- Staying hydrated with 6-8 glasses of water daily
- Avoiding irritants such as smoking, alcohol, caffeine, and spicy foods
- Voice therapy with a speech-language pathologist to improve vocal technique and reduce strain
- Medical treatments, such as anti-reflux medications, anti-inflammatory medications, or antibiotics, based on the underlying cause
- Surgical intervention for structural abnormalities
- Humidifying the environment and practicing proper breathing techniques to support vocal health
Importance of Voice Therapy
Voice therapy is a crucial component of managing voice changes, as it helps to improve vocal technique, reduce strain, and promote healing of the vocal cords.
- It involves exercises and strategies to modify vocal behaviors and improve communication
- A speech-language pathologist can provide personalized therapy to address specific needs and goals
Lifestyle Modifications
Lifestyle modifications play a significant role in managing voice changes and preventing further complications.
- Avoiding irritants and staying hydrated can help to reduce inflammation and promote healing
- Practicing good vocal hygiene, such as avoiding loud talking or screaming, can help to prevent further strain on the vocal cords
- Getting regular exercise and managing stress can also help to improve overall vocal health
Recent Guidelines
Recent guidelines, such as those published in 2021 1, emphasize the importance of a comprehensive approach to managing voice changes, including voice therapy, lifestyle modifications, and medical treatments.
- These guidelines provide evidence-based recommendations for clinicians to improve the quality of care for patients with voice changes
- They highlight the need for a multidisciplinary approach, involving speech-language pathologists, otolaryngologists, and other healthcare professionals, to provide comprehensive care for patients with voice changes.
From the Research
Approach to Managing a Change in Voice
The approach to managing a change in voice involves several steps, including:
- Accurate diagnosis of the underlying cause of the voice change, which is essential for appropriate treatment 2
- Evaluation of the patient's medical history, including any previous diagnoses or treatments for voice disorders
- Physical examination of the larynx and vocal cords, which may include videolaryngostroboscopy (VLS) or other imaging techniques
- Assessment of the patient's voice, including subjective and objective measurements, such as the Voice Handicap Index (VHI) 3
Diagnostic Considerations
When evaluating a patient with a change in voice, several diagnostic considerations must be taken into account, including:
- Reflux and its potential impact on voice disorders, although the evidence supporting a causal relationship is conflicting 4
- The presence of vascular defects or shape anomalies of the vocal folds, which can be evaluated using image processing techniques and machine learning methods 5
- The potential for chronic laryngitis to be a predisposing factor for laryngeal carcinoma, and the importance of early recognition and diagnosis 3
Treatment Options
Treatment options for voice disorders may vary depending on the underlying cause and diagnosis, but may include:
- Antibiotics or other medications to treat underlying infections or conditions
- Proton pump inhibitors to treat reflux-related symptoms
- Voice therapy to improve voice quality and reduce symptoms
- Surgical intervention in some cases, such as the removal of vocal cord lesions or other abnormalities 6
- Changes in diagnosis and treatment may occur after specialty voice evaluation, highlighting the importance of comprehensive evaluation and diagnosis 6