Page 128 - 16-27 Nov 13 2019

Voice Disorders and Therapy

There are many questions which people have asked me regarding voice disorders and
voice therapy; questions such as if I’m hoarse for a day should I have my voice checked out? My
voice suddenly became atypical one day and I’ve never had voice issues in the past, what may
have caused it? When should I go to an ENT? How long should voice therapy last? My hope is
that throughout a series of articles over the coming weeks I will be able to answer these and all
the questions that you may have in this regard.

Accordingly, let’s begin with the normal voice. Voicing is produced in three parts which
overlap. The three segments of vocal production are respiration, phonation, and resonation.

Respiration refers to the process of inhalation and exhalation (breathing in and out).
When one produces sound, such as when talking, laughing, crying, coughing, etc… air is
necessary to bring out the voice. While the actual process of breathing is quiet fascinating, for
the sake of brevity I will keep it short. On inhalation (breathing in) the air enters the mouth
and/or the nose and then follows through a series of important pipes, chambers of the vocal
tract, in to the trachea (wind pipe) and subsequently fills up in the lungs. The quality of the
breathing will help determine the amount of air inhaled. Again, air is pivotal for voice
production.

Once the air fills up in the lungs it then exits in the same way it came, back up the
trachea and into the larynx (structure which houses the vocal cords). The air then forces the
Bulletin
vocal cords apart which will quickly shut causing vibration. Each open and shut is called one
cycle. The amount of cycles per second is important because they are one of two factors which
determine the pitch of your voice. The voice is now made and travels up through the rest of the
larynx, through a tube called the pharynx (connects the nose, mouth, and top of the throat) and
comes out of the mouth and/or nose.

So now we’ve accomplished the respiration (breathing), phonation (producing sound),
and resonation…however what exactly is resonation?

Resonation is a term that is very famous in voice disorders and therapy. Resonation
refers to the vibration of sound which hits the roof of the mouth when exiting. Appropriate
resonance is pivotal in ensuring good vocal quality. Regarding many voice disorders, a
significant part of the therapy should incorporate some level of resonance rehabilitation.

Throughout the next few articles various voice disorders including vocal cord nodules,
polyps, cysts, etc... As well, the process of voice therapy will be explored. Stay tuned…

Yaakov Skovronsky MS, CCC – SLP is a Speech Language Pathologist specializing in voice
disorders. Yaakov has successfully treated many different speech/voice disorders for more than
a decade and is the therapist of choice of many doctors in Brooklyn and Manhattan. He can be
reached at his Boro Park Office at 718-851-1464 or at his Williamsburg office at 917-272-5796.