Taking care of your voice

Structures involved in speech and voice production

What is voice?

The sound of your voice is produced by the vibration of the vocal cords, which are two bands of smooth muscle tissue positioned opposite each other in the larynx. The larynx is located between the base of the tongue and the top of the trachea, which is the passage to the lungs (see figure).

When you’re not speaking, the vocal cords are open so you can breathe. However, when it is time to speak, the brain orchestrates a series of events. The vocal cords tighten as air passes through the lungs, causing them to vibrate. The vibrations produce sound waves that pass through the throat, nose and mouth, which act as resonant cavities to modulate sound. The quality of your voice (its pitch, volume, and tone) is determined by the size and shape of the vocal folds and resonant cavities. That’s why people’s voices are so different.

Many people use their voice for their work. Singers, teachers, doctors, lawyers, nurses, salespeople, and public speakers are among those who are very demanding when it comes to their voices. This puts them at risk of developing voice problems. In the United States, approximately 17.9 million adults report voice problems. Some of these disorders can be avoided by taking care of your voice.

How do you know if your voice is unhealthy?

If you answer “yes” to any of the following questions, you may have a voice problem:

• Has your voice become hoarse or hoarse?
• Have you lost your ability to hit high notes when singing?
• Does your voice suddenly sound deeper?
• Is your throat often irritated, sore or tight?
• Has it become an effort to speak?
• Do you find yourself clearing your throat repeatedly?

If you think you have a voice problem, see a doctor to determine the underlying cause. A doctor who specializes in diseases or disorders of the ears, nose, and throat, and who can best diagnose a voice disorder, is an otolaryngologist (oh-toe-lar-in-GAH-luh -jist), sometimes called ENT. Your otolaryngologist can refer you to a speech therapist. A speech therapist can help you improve the way you use your voice.

What causes voice problems?

Causes of voice problems include:

• Upper respiratory infections
• Inflammation caused by gastroesophageal reflux disease (sometimes called acid reflux, heartburn, or GERD)
• Misuse and excessive use of voice
• Growths on the vocal cords, such as vocal nodules or laryngeal papillomatosis
• Laryngeal cancer
• Neurological diseases (such as spasmodic dysphonia Or vocal cord paralysis)
• Psychological trauma.

Most voice problems can be resolved by treating the underlying cause or through a range of behavioral and surgical treatments.

Healthy habits to take care of your voice

Stay hydrated:

• Drink plenty of water, especially when you exercise.
• If you drink caffeinated drinks or alcohol, balance your intake with plenty of water.
• Take vocal naps: Rest your voice throughout the day.
• Use a humidifier in your home. This is especially important in winter or dry climates. Thirty percent humidity is recommended.
• Avoid or limit the use of medications that can dry out the vocal cords, including some cold and allergy medications. If you have voice problems, ask your doctor which medications would be safest for you.

Maintain a healthy lifestyle and diet:

• Do not smoke and avoid second-hand smoke. Smoke irritates the vocal cords. Additionally, vocal cord cancer is most commonly seen in smokers.
• Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or esophagus, causing heartburn or GERD.
• Include plenty of whole grains, fruits and vegetables in your diet. These foods contain vitamins A, E and C. They also help keep the mucous membranes lining the throat healthy.
• Wash your hands often to avoid catching a cold or the flu.
• Get enough rest. Physical fatigue has a negative effect on the voice.
• Exercise regularly. Exercise increases endurance and muscle tone. This helps ensure good posture and breathing, necessary for speaking correctly.
• If you have persistent heartburn or GERD, talk to your doctor about diet changes or medications that can help reduce flare-ups.
• Avoid mouthwashes or gargles that contain alcohol or irritating chemicals.
• Avoid using mouthwash to treat persistent bad breath. Halitosis (bad breath) may be the result of a problem that mouthwash cannot cure, such as mild infections of the nose, sinuses, tonsils, gums, or lungs, as well as a reflux of gastric acid from the stomach.

Use your voice wisely:

• Try not to overuse your voice. Avoid speaking or singing when your voice is hoarse or tired.
• Rest your voice when you are sick. Illness puts additional stress on your voice.
• Avoid using the extremes of your vocal range, such as shouting or whispering. Speaking too loudly and too quietly can stress your voice.
• Practice good breathing techniques when singing or speaking. Support your voice by breathing deeply from the chest and don’t rely solely on your throat. Singers and speakers are often taught exercises that improve this type of breath control. Speaking with your throat, without holding your breath, puts a strain on your voice.
• Avoid rocking the phone when talking. Holding the phone between your head and shoulder for long periods of time can cause muscle strain in your neck.
• Consider using a microphone when appropriate. In relatively static environments such as exhibition areas, classrooms or exercise rooms, a lightweight microphone and amplifier-speaker system can be of great help.
• Avoid speaking in noisy places. Trying to speak above noise causes strain on the voice.
• Consider voice therapy. A speech therapist experienced in treating voice problems can teach you how to use your voice in a healthy way.

What voice research does the NIDCD support?

The National Institute on Deafness and Other Communication Disorders (NIDCD) supports research that includes laboratory studies to understand diseases and stress that can damage the voice, as well as clinical research to test new ways to diagnose, treat or cure voice disorders.

Researchers study how the brain controls the muscles and nerves of the larynx and tongue, and how these structures move to produce speech. This information could help other scientists design better treatments for conditions such as vocal cord paralysis and spastic dysphonia, which can damage the voice. It could also help researchers design new rehabilitation strategies to improve the quality of life of people with severe voice disorders.

Another area of ​​interest for researchers is the development of replacement tissues to repair damaged vocal cords. NIDCD-funded scientists are testing artificial and biological materials and stem cell technologies that could potentially be used to engineer new vocal fold tissues, as well as methods to encourage nerve regrowth to treat laryngeal paralysis.

Researchers are also studying new ways to assess vocal disorders and testing new voice therapy methods for people with growths on the vocal cords. Research continues to explore ways to prevent vocal cord scarring after injury and to treat vocal cord scarring when it occurs. Other ongoing research studies aim to understand the mechanisms of laryngeal papillomatosis caused by HPV (human papillomavirus) and to develop new drug treatments for this disease.

New techniques to combat age-related laryngeal muscle weakness could potentially prevent voice disorders in the aging population. Recent results from NIDCD-funded researchers showed that, in an animal model of aging voice, voice training exercises helped the laryngeal muscles stay strong.

Because teachers have a high incidence of voice disorders, the NIDCD is supporting the development of an educational website for teachers to promote healthy behaviors and protection of their voices. The NIDCD also supports research into the effectiveness of vocal hygiene education and vocal production training for teachers.

Where can I find additional information about voice and voice disorders?

The NIDCD maintains a directory of organizations which provide information about the normal and disordered processes of hearing, balance, taste, smell, voice, speech and language.