Voice, swallowing, and airway disorders sometimes require a therapist to guide patients toward functional rehabilitation through a variety of techniques. At The Voice Clinic of Indiana, speech and language pathologists (SLPs) with extensive experience and training provide care to patients with a range of underlying medical problems. Special to The Voice Clinic of Indiana is the opportunity to work with therapists who have specific expertise in vocal rehabilitation, which often affects those who use their voices professionally, such as singers, teachers, lawyers, lecturers, politicians, and ministers. Described below are some general concepts behind the major areas of therapy provided by our SLPs.
Dysphonia, or hoarseness, is a change in the quality of one’s voice. Whether a professional voice user or not, voice is an essential part of communication, identity, and quality of life. Patients with dysphonia may have developed an underlying structural problem or a sub-optimal pattern of voice production. Voice therapy focuses on optimizing the configuration of the vocal cords, reducing muscle tension, addressing stress, enhancing posture, and improving breathing as related to voice production. Depending on the disorder being addressed, some or all of these elements will be attended to in detail. There are also some specific voice therapy regimens, such as Lee Silverman Voice Therapy for patients with Parkinson’s disease. Regardless of the underlying disorder, voice therapy is specifically tailored to each patient with the ultimate goal of voice and speech rehabilitation that allows patients to meet their vocal demands. Voice therapy may be the primary treatment or may be used to enhance medical and/or surgical management.
Dysphagia is the development of difficulty swallowing or a change in one’s swallowing from baseline. Aspiration is the pathological entry of material, often solid food or liquids, past the vocal cords and into the lower airway. Some patients have restricted diets that specify certain consistencies of food or liquids that allow for a safe swallow, while others may not be able to swallow safely at all. Various exercises and techniques may improve the ability to swallow foods. Dysphagia and aspiration negatively impact patients quality of life in a significant way. Swallowing therapy focuses on helping patients swallow more safely and effectively through the use of exercises and/or specific techniques. Exercises aim at strengthening swallowing muscles and improving coordination. Specific techniques, such as the supraglottic swallow or Mendelson maneuver, can improve effort and optimize airway protection. Finally, SLPs are experts in the use of special instruments to aid in swallowing, such as the use of special cups or spoons for certain individuals. Similar to voice therapy, swallowing therapy may be a sole treatment or may be used as an adjunct to medical or surgical management.
There are some disorders that can be treated using therapy offered by SLPs that are not voice or swallowing disorders. For example, paradoxical vocal fold dysfunction is a disorder of restricted breathing due to abnormal vocal cord movement. The symptoms related to this disorder can be cured with techniques taught to modulate breathing. As another example, chronic cough may not reveal an underlying cause after a thorough medical workup. When medical therapy fails to resolve patient symptoms, exercises and techniques learned through therapy can help some patients.