What is Voice Therapy? Who Is It For and How Is It Applied?

If you have noticed a change in your voice or are having difficulty speaking, voice therapy may be able to help you. Voice therapy is a treatment method that heals your vocal cords and improves voice quality.

In this article, we will examine topics such as voice therapy exercises, how to perform voice therapy at home, and voice therapy for vocal cord nodules in detail. You will also learn who can benefit from this treatment and about the treatment process.

What is Voice Therapy?

Definition of Voice Therapy

Voice therapy is a medical and therapeutic approach used for the diagnosis, treatment, and improvement of voice disorders. In our country, voice therapy is conducted by Speech and Language Therapists. These specialists are individuals who have received specific training in voice and speech disorders.

The primary goal of voice therapy is to treat issues such as hoarseness and voice loss. Therapy specialists teach individuals how to use their voices correctly. Furthermore, it aims to restore the balance between respiration-phonation and resonance for healthy voice production.

Voice therapy is quite important for professional voice users, such as teachers, call center employees, clergy, vocal artists, and theater actors. Since these professional groups use their voices with high performance, they are more prone to damage. Therefore, receiving voice training before damage occurs will prevent significant loss of labor and performance decline.

Causes of Voice Disorders

Voice disorders can stem from various factors. Depending on the cause, voice disorders can be classified as organic structural, organic neurogenic, and functional.

Common causes of voice disorders include:

• Incorrect voice usage: Speaking loudly, talking too much, shouting, and speaking in a tense and stressed manner damage the vocal cords. Using the voice at the wrong pitch also leads to problems.
• Tissue growths: Extra tissues such as nodules, polyps, cysts, or granulomas can form on the vocal cords. These tissues prevent the vocal cords from functioning normally.
• Inflammation and swelling: Respiratory tract diseases, allergies, acid reflux, and smoking and alcohol use can cause inflammation and swelling in the vocal cords.
• Nerve problems: The nerves that control the vocal cords can be damaged as a result of surgical intervention or chronic laryngitis. It also includes disorders that arise due to certain neurological conditions.
• Excessive voice use: Excessive straining of the voice can cause the vocal cords to develop nodules and polyps.

Functional voice disorders arise from the inadequate or incorrect use of the larynx and diaphragm without anatomical or neurological abnormalities.

Working Principle of the Vocal Cords

The vocal cords are two mucosal membrane layers located in the laryngeal cavity. They are the main organs responsible for voice production. Sounds are created as a result of the air coming from the lungs during breathing vibrating the vocal cords as it passes between them.

Voice production begins with the vocal cords approaching each other and vibrating. These vibrations turn air into sound waves. The tension and openness of the vocal cords determine the pitch and tone of the voice. Muscles controlled by the brain stretch and relax the vocal cords.

In women and children, the vocal cords are short and thin. For this reason, women's and children's voices are higher-pitched compared to men's. The frequency of these vibrations determines the pitch of the voice. For normal speech, the vocal cords must touch each other properly within the larynx.

Who Is Voice Therapy Applied To?

Voice therapy is applied to individuals experiencing specific health problems. Speech therapy is widely preferred in the treatment of voice disorders, and in some cases, the problem can be treated solely with this method.

Laryngitis and Hoarseness Issues

Laryngitis manifests itself with hoarseness and sore throat as a result of inflammation in the laryngeal region. This swelling in the vocal cords causes difficulty in speaking. It usually occurs due to viral infections and can heal in a short time.

Acute laryngitis starts suddenly and passes within a few weeks. A virus in the upper respiratory tract is seen as the primary cause. Chronic laryngitis, on the other hand, lasts longer than three weeks. People who strain their voices for long periods, such as teachers, singers, and theater actors, carry a risk of chronic laryngitis. If left untreated, permanent damage to the vocal cords may occur.

Among the most common causes of hoarseness are shouting, speaking loudly, and reflux. Since acid creates irritation in the throat, constant hoarseness can occur. In mild cases, resting your voice and drinking plenty of fluids is sufficient.

Muscle Tension Dysphonia

Muscle tension dysphonia is a functional disorder caused by the incorrect use of the laryngeal muscles that play a role in voice production. This condition is generally seen in people who are stressed and use their voices intensively. Faulty speaking techniques and psychological factors are the main contributing factors.

Upper respiratory tract infections and reflux are significant risk factors. Tension in the throat area is detected via palpation. During phonation, the larynx rises and the voice sounds strained. Half of the patients diagnosed with muscle tension dysphonia have a faulty voice usage technique.

Voice therapies play the essential role in treatment. During therapy, relaxation exercises are applied to control breathing, ensure the correct vibration of the vocal cords, and reduce tension in the relevant muscles. If there are psychological reasons, psychotherapy is also needed.

Vocal Cord Nodules and Other Lesions

Vocal cord nodules are small masses that form as a result of excessive use of the vocal cords. They develop due to incorrect or excessive use of the voice. They can be compared to calluses on the feet. They are more common in people who use their voices frequently due to their profession, such as teachers, clergy, call center employees, and singers.

Nodule symptoms are usually hoarseness and quick fatigue during speech. Vocal cord nodules can be treated with voice therapy. If noticed in the early stage and correct voice usage is learned, they can often regress completely on their own or with voice therapy. Voice therapy is sufficient on its own in the treatment of most nodules.

Vocal polyps are usually soft-tissue lesions that form on a single vocal cord. They can emerge as a result of sudden voice strain, shouting, or smoking. Improvement is possible with voice therapy in small polyps. Vocal cord cysts, on the other hand, form as a result of the blockage of moisturizing glands.

Vocal Cord Paralysis and Functional Disorders

Vocal cord paralysis occurs with damage to the nerves that control the vocal cords. Thyroid surgery, viral infections, or trauma are the most frequent causes. Symptoms such as permanent hoarseness, a breathy or weak voice, and difficulty swallowing are seen.

In mild cases, the patient's process is monitored and voice therapy can be applied. Voice therapy is a suitable treatment option for patients with vocal cord paralysis. Voice therapy enables patients to regain their voice quality. In the post-surgical period, the quality and power of the voice are also increased with voice therapy.

How Is Voice Therapy Applied?

Specialists Conducting the Therapy

The medical diagnosis of a voice disorder is made by ENT (Ear, Nose, and Throat) physicians. After the source of the problem is identified, the appropriate method among medical treatment, surgical intervention, or voice therapy is chosen.

Speech and Language Therapists take part in voice therapies. While voice therapy is sufficient on its own in some cases, in other cases, therapy training needs to be provided before or after surgical intervention. The ENT specialist examines hearing problems and vocal cord issues. The neurology specialist, on the other hand, steps in for speech disorders originating from the brain.

Evaluation and Treatment Plan

Before starting therapy, the factors underlying the individual's voice problem must be known. Imaging of the vocal cords, analysis of the voice, and evaluation of symptoms are performed at this stage.

A therapy process suitable for the individual's needs is planned, and the patient actively participates in this planning. Sessions take place at certain intervals and are held in a comfortable environment. Since each individual's voice problem may differ, the support process is planned in a personalized manner.

There are three main components of voice therapy methods:

• Education: The person learns the nature of the problem and how their way of using their voice contributes to the problem.
• Vocal Hygiene: Used both to prevent the development of the problem and to support the treatment.
• Direct Vocal Exercises: Developed to meet each person's specific needs.

After the evaluation, appropriate goals are set, and the support process is structured. Programs are constantly monitored during sessions and changed when necessary.

Voice Therapy Exercises

Voice therapy exercises are critically important for protecting the health of the vocal cords. The humming exercise gently warms up and relaxes the vocal cords. Producing sound by breathing from the diaphragm reduces the pressure on the vocal cords.

Diaphragmatic breathing applies less pressure to the vocal cords and increases the power of the voice. Lip trills increase the resonance of the vocal cords and help the voice sound fuller.

The Lax Vox technique can be used for different voice disorders. In this technique, a silicone tube 30-35 cm in length is placed in a bottle containing warm water. The patient blows into the tube while holding it between their front incisors. These exercises are initially given 1 minute per hour, 10-12 times a day.

Resonance voice therapy, vocal function exercises, and laryngeal massage are among the example applications. The points learned in therapy must be put into practice.

How to Perform Voice Therapy at Home

Continuity of treatment is ensured with home exercises. First, perform neck muscle and shoulder relaxation exercises for at least 10 minutes.

Abdominal breathing needs to be learned. Lie on your back and place one hand on your chest and the other on your abdomen. Feel your abdomen swell when you inhale. Inhale as if smelling a flower, exhale as if blowing out a candle. Do this for 5 minutes to establish the basic breathing practice.

In vowel prolongation exercises, vowels such as a, o, u are prolonged individually while exhaling. Work is done until the exhalation time is 8-10 times the inhalation time. During book reading, inhalation points are marked, and the text is read in 8-10 word segments.

It is recommended to apply every few days in the first sessions. Once you are sure you are doing the exercises correctly, the duration can be increased to 3-5 minutes.

Benefits and Process of Voice Therapy

Advantages of the Treatment

Voice therapy provides many benefits. Increasing voice quality is one of the most important gains. Your voice sounds clearer and stronger. Hoarseness is treated, and speech discomforts are resolved.

It is of great importance for professional voice users such as singers and teachers. Vocal health is protected and improved. It restores natural voice quality. It increases vocal endurance and reduces fatigue. Symptoms such as hoarseness, strain, or pain are minimized.

It prevents further damage to the vocal cords. It improves vocal performance for professionals. Voice therapy not only fixes problems but also ensures that individuals use their voices confidently and sustainably. It provides long-term recovery by addressing both physical and behavioral aspects.

An individual who receives surgical treatment but continues their life without receiving voice therapy may repeat the same incorrect behaviors, paving the way for the same damage to occur again. Accordingly, receiving voice therapy after surgery is of vital importance.

Treatment Duration and Expectations

Voice therapy is generally applied as 8-10 sessions and lasts 1-2 months. Therapy lasts on average between 6-8 weeks. Sessions last about 40 to 50 minutes. How many sessions the application will last may vary depending on the problem the individual has or the gains they want to achieve.

The treatment duration may vary depending on the patient's condition and response to treatment. The therapy duration changes according to the individual's condition, goals, and commitment to practice. While some people get results within weeks, others may need work that lasts several months.

The length of treatment can generally vary from a few weeks to a few months. Coupled with the patient's adherence to the treatment plan is very important. Voice therapy is generally a time-consuming process. In this process, the individual must be patient and not lose their motivation.

Exercises performed in therapy sessions should be done regularly at home. It is important that patients participate in the treatment appropriately. Recommendations such as voice rest, doing the necessary exercises, using medication when necessary, and maintaining a healthy lifestyle should be followed.

Methods for Protecting Vocal Health

Vocal hygiene measures also show protective effects in stomach and throat reflux diseases. Healthy eating, drinking plenty of fluids, and regular exercise have positive effects on overall body health.

You should consume at least 2 liters of fluid per day. The necessary hydration for the vocal cords should be provided by drinking 8-10 glasses of water per day. Get plenty of oxygen. Do not speak too fast and breathe more often. Breathing deeply and abdominally through the nose is the correct technique.

Stay away from cigarettes. Do not smoke. Smoking dries out the entire vocal tract, starting from the lips. Do not consume very spicy, sour, or excessively seasoned foods. Stop food intake 3 hours before going to bed. Otherwise, increased stomach acid throughout the night will damage your vocal cords.

Clearing your throat and coughing frequently damages the vocal cords. When you feel the need to clear your throat, swallow or drink some water. Stress creates muscle tension, causing strained use of the voice. Shouting and screaming can cause bleeding in the vocal cords, causing permanent damage to voice quality.

Frequently Asked Questions

Voice therapy is generally applied as 8-10 sessions and lasts 1-2 months. Each session lasts about 40 to 50 minutes. However, this duration varies from person to person.

How many sessions the application will last varies according to the problem you have or the gains you want to achieve. For example, mild problems such as vocal fatigue can last 6-10 sessions. In advanced cases such as vocal nodules, it can go up to 20-30 sessions.

The first sessions can be held at intervals of a few days. Once it is ensured that you are doing the exercises correctly, the sessions become more spaced out. On average, the therapy process is around 2 months.

Yes, voice therapy sessions can also be done at home. Exercises done at home accelerate the healing of your voice. Voice therapy is one of the areas that best adapts to online therapy.

Exercises and vocal hygiene education can be conveyed completely via video. The therapist can record the session and evaluate the acoustics of the home. In some cases, this is more advantageous than the clinic.

The success of the home program depends largely on what you do outside of the sessions. The daily exercise set takes 10-15 minutes. Adequate water consumption, voice rest, and reflux management are the basic elements that must be applied at home.

Voice therapy focuses on correcting voice quality, pitch, resonance, and intensity. Voice disorders occur due to various diseases or voice abuse.

Speech therapy, on the other hand, addresses speech disorders such as articulation, stuttering, and language development. It includes sequencing activities or language-based games for children. It focuses on improving specific skills for adults.

Speech and Language Therapists take part in voice therapy. In some cases, voice therapy is sufficient on its own, while in some cases, therapy is required after surgical intervention.

In case of hoarseness that starts without any upper respiratory tract infection and lasts longer than 2 to 3 weeks, a specialist physician must be consulted. You should go to the doctor in case of hoarseness lasting longer than 15 days.

Consult without delay in the following cases:

• If there is a sudden and unexplained change in the voice
• If you feel pain while speaking or singing
• If your voice gets tired quickly
• If you feel the need for increasingly louder voice usage

After vocal cord surgery, a doctor should be consulted in cases of difficulty breathing, severe pain, constant hoarseness, and difficulty swallowing.

The healing process varies from person to person. After vocal cord surgeries, full vocal recovery and reaching the final quality of the voice can take 6 to 12 weeks.

Vocal cord paralysis can heal on its own in 3-6 months. Voice therapy can be received for easier healing. Voice therapy, which is started under the supervision of a specialist from the 2nd week after surgery, prevents returning to old faulty habits.

The treatment duration may vary depending on your condition and response to treatment. Therefore, it is important that you be patient and not lose your motivation.

In Summary, Voice Therapy

Voice therapy is an effective and safe method to solve your voice problems. If you are experiencing hoarseness, fatigue, or pain, this treatment may be able to help you. It is of great importance especially for teachers, singers, and professionals who use their voices intensively. Therapy generally lasts 8-10 sessions, and you can also apply it at home with the right exercises. Surprisingly, many voice problems can be treated without surgical intervention. Consult a specialist for voice changes lasting longer than two weeks. Your voice is an important part of your health, and with proper care, you can use it healthily for many years.

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