Page 39 - 16-34 Jan 1 2020

Voice Disorders and Therapy

Before going further in our discussion of various physical vocal disorders, I would like to
address a voice issue which while fairly uncommon, is something which CAN be addressed
through voice therapy and is a genuine voice problem.

A few years ago, while spending a few sessions with a well-known ENT at his practice, I
had the occasion of observing a patient who demonstrated a rather atypical sounding voice. It
was clear that this could not have been his regular voice. What was surprising was not that this
patient was hoarse, or breathy, strained, or raspy, to the contrary his voice sounded relatively
smooth; Rather this patient had an unusually high-pitched voice which as mentioned earlier
clearly did not match the way he appeared as a person.

After speaking with this man for a few minutes, it became clear that he had gone
through a very difficult time a couple of years prior which is when the voice issue began.
Subsequently, he had adapted to using this atypical voice, and finally decided to address it.
Voice therapy was then recommended by the ENT.

In my experience, I have had quite a few patients with either this or comparable like
types of issues which were successfully remediated through voice therapy. Often the therapy is
relatively quick and the symptoms do not usually return.

Let’s now return to physical voice disorders, specifically Sulcus Vocalis. This vocal cord
pathology refers to a groove or furrow in the vocal cord or cords depending if it is unilateral
(one cord) or bilateral (both cords).

There are three types of Sulcus Vocalis; and for the sake of understanding, I will try to
explain on a very basic level. The first type of SV is where the groove or furrow is on a very
superficial layer of the vocal cords and this results in typically normal voicing. In the second
type, the groove goes a bit deeper and there is some level of voice disturbance. And in the
third type of SV the furrow goes excessively deep in the vocal cord(s) and there is significant
dysphonia or atypical voicing. Symptoms of dysphonia are generally hoarseness, breathiness,
and increased effort to bring out the voice.

In the next article we will discuss causes and treatments for sulcus. As well, we will
address the definition of vocal cord paralysis, and its causes and treatments.