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Professional "Voice Abusers" Find Help At The New York Eye and Ear Infirmary (2001)
-- "Professionals, not just opera divas, can abuse their vocal chords and develop whispering, scratchy, high pitched or breaking voices that are a detriment to their careers and social lives," says
Janet Rovalino, MS,
CCC-SLP, chief of The New York Eye and Ear Infirmary’s Speech Pathology Service and a key member of its Center for Voice Disorders.
"Dysphonia, the abnormal production of vocal sounds, affects small business owners, teachers, telemarketers, sales representatives, news reporters -- even Presidents." Of several hundred patients treated at the Voice Center in the past year, most of whom are professional voice users, the problems and solutions range the
scales:
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an entrepreneur who, just prior to taking his computer firm public, totally lost his voice because he had burned the interlocking arytenoid cartilage in his voice box with acid reflux from an overdose of health food drinks;
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a 28 year old resident physician at The New York Eye and Ear Infirmary who was having difficulty communicating with patients because of a severe breaking voice and who now receives botulinum toxin injections;
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a vocal music student at SUNY who could not "range" her voice because of vocal fold nodules and who had to learn more efficient breathing patterns that allowed her to sing with less strain; and
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an insurance executive who came to The New York Eye and Ear Infirmary for a sinus problem but discovered she had a more serious voice condition.
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Technology and Teamwork -- Treatments for Special Disorders
Most voice abusers who are diagnosed with standard voice problems can be back on track with a combination of home therapy and six-to-ten sessions at the Voice Center. Basic education in vocal techniques -- such as avoiding overuse of laryngeal muscles, cutting back on late night snacks, or more effective breathing for speech -- is instrumental in correcting the vocal abuse. "For patients with special problems, such as spasmodic
dysphonia, The New York Eye and Ear Infirmary has a sophisticated armamentarium of voice evaluation technology and a team of world-class experts -- surgeons, physicians, speech pathologists, speech physiologists and even electrical engineers," said Steven Schaefer, M.D., chair of the Department of Otolaryngology and Communicative Disorders.
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Voice
Evaluation Lab -- Measuring Pitch and Shimmer
The New York Eye and Ear Infirmary’s
Center for Voice Disorders allows patients and therapists to actually
"see" their problems. Sophisticated computer systems measure a
patient’s pitch, jitter and shimmer (vocal irregularity), air flow,
harmonics-to-noise ratio and a host of other factors. These components of
the voice can then be visualized on a computer monitor. Once the
center’s team of experts has analyzed, isolated and verified the voice
problem appropriate modes of treatment are suggested.
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Diagnosing a Complex Case of Spasmodic Dysphonia
When the insurance executive came to The New York Eye and Ear Infirmary complaining of a sinus problem, some of her symptoms made the physicians suspect that she also had a vocal ailment. In fact, a preliminary examination led them to believe she had spasmodic
dysphonia, a disabling vocal condition due to neurological malfunction. To verify this assumption, The New York Eye and Ear Infirmary's Voice Center team -- including Dr. Schaefer, Ms. Rovalino, and Ronald J. Baken,
Ph.D, vocal physiologist -- conducted a battery of tests:
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Videostroboscopy -- an advanced imaging technique using a minute camera to observe the movement of the vocal cords in slow motion.
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Sound Spectrography -- a method of acoustical analysis that helped to characterize the nature of the interruption in the executive’s voice.
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Electroglottography -- a way of exploring the physiology of the voice that elucidated subtle details of how the vocal cords contact each other.
Information from these sources was combined by the laboratory’s multichannel data acquisition system to create a picture of the executive’s vocal malfunction. On the basis of the test findings, the team could pinpoint the nature of the problem (it was spasmodic
dysphonia), get an accurate assessment of its severity and recommend a treatment -- botulinum toxin injections.
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