The voice needs to be protected not only by professional vocalists, for whom it is a working instrument and a source of income, but also by everyone who has to work with people. For a production worker, freelance programmer or truck driver, loss of voice is a minor nuisance, no worse than a runny nose or a slight bruise, but for a manager, salesperson, operator, dispatcher it is a missed day of work. If the problem is serious, you can lose both your job and your specialty overnight. Be sure to study materials on the prevention and prevention of voice breakdowns and vocal cord injuries, since preventing a problem is always easier than solving it.
Be sure to study materials on the prevention and prevention of voice breakdowns and vocal cord injuries, since preventing a problem is always easier than solving it. If trouble has already happened, then this article will help you find out what to do in such a situation: how to competently help yourself or a friend, how to quickly restore your voice, and what not to do so as not to cause even more harm. You will learn even more on this topic by enrolling in a public speaking course or acting classes at the Benefis theater studio.
Symptoms
Voice disorders with this pathology are manifested in hoarseness or hoarseness of timbre, decreased voice strength, decreased tonal range, vocal fatigue, and unpleasant sensations in the larynx. Breathing becomes shallow, phonation exhalation is reduced. The degree of voice impairment varies from mild to severe, making it difficult to perceive speech. All this can lead to the impossibility of fulfilling one’s professional duties and complicates communication at home. Symptoms of voice changes should not be ignored. It is necessary to contact a phoniatrist in a timely manner.
Effective exercises for hoarseness
The voice is the most important tool we need to communicate and express ourselves. And if something happens to the voice - from hoarseness to its complete loss - then this becomes a real problem. Frequent colds and all kinds of throat diseases (laryngitis, pharyngitis, sore throat) can lead not only to hoarseness, but also to complete loss of voice. Dry air (including from air conditioning), dust, and smoking are also enemies of our voice. At risk are people who, due to their profession, often have to strain their vocal cords: teachers, singers, announcers, tour guides, managers, etc. Voice problems can arise even from such pleasant activities as attending a football match and singing karaoke. Due to increased stress, the voice shrinks, hoarseness, cough, and a feeling of discomfort in the throat appear.
Prevention of hoarseness
Is it possible to prevent voice problems, especially if your job requires you to talk a lot? Foniators advise adhering to these recommendations.
- If at work you are forced to talk for a long time, change your intonation in conversation more often. This “exercise” trains your vocal cords well. At the same time, avoid raising your tone so as not to overstrain them.
- If possible, communicate on the phone as little as possible, since in this case the voice puts more strain on it than in a normal conversation.
- Try to do special exercises every day. They will help improve the functioning of the vocal cords and make it easier to bear speech loads.
Voice exercises
- Say the syllables “kyuu-iks” 20–30 times: on the syllable “kyuu” round your lips, on the “iks” stretch them into a smile. Then take a breath and slowly pronounce the consonant sound “m” or “n”. Direct it upward into the nasal cavity, while placing your fingers folded together on both sides of the nose. Vibration should be felt underneath them.
- As you exhale, chant the letter combinations several times: “mi-mi-mi”, “ma-ma-ma”, “mu-mu-mu”. This is exactly what singers do when they sing. Then try to read any sentence, first pronouncing only the vowels, and then only the consonants. Do this 5-7 times.
- Place your hands on your solar plexus and say any text, trying to make the sounds come from your stomach. At the same time, open your mouth wide and clearly articulate your consonants.
- Say the phrase several times: “You should speak not with your throat, but with your nose.” Try to speak through your nose to make the sound sound “cold.” This exercise is great for relaxing tense ligaments.
For preventive purposes, to protect the respiratory tract and prevent increased stress on the ligaments, you can use lozenges based on Icelandic moss Isla Mint and Isla Moos. They have a protective, anti-inflammatory, immunomodulatory and antimicrobial effect in inflammatory processes and are excellent for those who suffer from laryngitis, pharyngitis, bronchitis, as well as all those who experience increased stress on the ligaments.
Examinations and treatment
In the Phoniatrics of the Federal State Budgetary Institution NKCO FMBA of Russia, high-tech endoscopic research methods are widely used, such as:
— videolaryngostroboscopy – a method that allows you to assess the macromorphological function of the larynx (XION medical);
- high-speed video laryngostroboscopy - a method with high image clarity makes it possible to obtain up to 4,000 color images per second and dynamically record 20 images during one period of oscillation of the vocal folds (Richard Wolf apparatus);
— video fibronasopharyngolaryngoscopy – a method that allows diagnosing cancer in situ, epithelial dysplasia of varying degrees, as well as diagnosing precancerous diseases of the larynx by obtaining a full-fledged high-definition image;
— NBI — narrow-spectrum endoscopy is one of the most modern technologies introduced into practice, which allows a specialist to visualize all changes in the vascular structure of the mucous membrane, typical for neoplasms (Olympus OEV261H, CV-170).
Using these modern methods, a specialist will be able to make an accurate diagnosis of the patient and prescribe appropriate treatment. After this, it is necessary to begin rehabilitation of vocal function as soon as possible.
Voice restoration is possible using a non-surgical method - phonopedia.
Common voice restoration problems in children
Voice restoration in children with organic diseases of the larynx is a complex and lengthy process.
The difficulties of speech therapy work with these children are due to several negative factors, of which the main importance is the violation of the anatomical integrity of the larynx as a result of repeated operations to remove tumors, excision of scars of the larynx, as well as the early development of laryngeal disease (usually before 3 years) and its adverse effect on the psychophysical and speech development of the child. All of these factors dictate the need to conduct speech therapy classes, taking into account the developmental characteristics of the child’s body, using the basic didactic principles of pedagogy: clarity, accessibility, gradual complication of the material. A young child sometimes does not understand the requirements placed on him and does not show interest in classes. Therefore, he needs to be interested in bright, visual material, all explanations must be given in a simple, figurative and understandable form, and games must be widely used. The positive result of speech therapy work is achieved thanks to the great compensatory capabilities of the child’s body to restore lost function. In a child, these capabilities are higher than in adults, and the lost function is restored faster and better when appropriate favorable conditions for development, upbringing and learning are created. Thus, in children with organic voice disorders, as a result of speech therapy sessions, the role of deformed or absent true vocal folds is taken over by false folds, forming a false vocal fold.
The difficulties of speech therapy work on voice restoration in children are also due to the fact that insufficient attention is paid to this issue in the specialized literature. Numerous works by Russian vocal teachers and phoniatrists are devoted mainly to the development and protection of the singing voice in adults and children, as well as the restoration of functional voice disorders in adults. Most researchers suggest a number of orthophonic exercises (mainly voice exercises) to restore voice in adults. Some of these exercises were used in working with adult patients who suffered from laryngeal stenosis due to gunshot wounds, injuries, and laryngeal tumors.
As for organic voice disorders in children, there are only descriptions of isolated observations regarding the etiology of voice disorders, the clinical picture of the larynx in these children, and certain methodological techniques for voice restoration.
According to some experts, changes in voice and breathing are the first symptoms of laryngeal disease. Surgical intervention on the larynx disrupts the closing function of the vocal folds and the normal sound of the voice. In this case, hyperfunction of the false folds and the formation of a false ligamentous voice are noted. Its timbre is unpleasant, even croaking, monotonous, rough, hoarse, compressed.
Modern restorative speech therapy achieves its goal of restoring lost body function using the most humane, non-traumatic methods for the patient. When restoring your voice, it is advisable to use so-called gentle therapy. G. Schoppe, back in 1888, pointed out the importance of massage, which acts on the muscles and mucous membrane of the larynx, regulates blood circulation, and reduces the amount of mucus. The foundations of orthophonic treatment were laid at the end of the 19th century. Thus, in the treatment of phonasthenia and functional aphonia, articulatory gymnastics, breathing exercises, general body exercises, vibration, and electric voice plugs were recommended. G. Gutzman pays special attention to the patient’s speech regime - absolute rest for 8-10 days. To obtain the first sound, he proposed the method of buzzing or mooing, while the choice of working method depends on the individual characteristics of the patient’s voice. G. Gutzman was the first to propose a more or less coherent system of work to restore functional voice disorders.
A complex treatment method - phonic orthopedics - was used for functional voice disorders. It included: 1) psychotherapy; 2) education of lower costal diaphragmatic breathing; 3) articulatory gymnastics (first without the participation of the voice, then the patient was asked to pronounce words in a whisper); 4) exercises with loud sound.
The patient could regulate the pitch and strength of his voice by changing the force of exhaled air. Some phoniatrists, when restoring functional voice disorders, used the method of vibration-phonic orthopedics, the main component of which is manual and vibration massage of the larynx in combination with voice exercises (m, mu, we). First, exercises were carried out in conjugate phonation, then in reflected and finally in spontaneous.
Subsequently, the method of phonic orthopedics was supplemented by muffling and rhythmic shaking (seismic therapy). After carrying out a regime of silence, articulation and breathing exercises, the patient stands on a shaking-noise platform, and at this moment he is asked to moo. To obtain the first phonation, one to three sessions are enough. If it is not possible to obtain a voice during the first sessions, further use of therapy is useless. A faster effect is achieved by untreated patients and children with greater emotional excitability.
Physical therapy and speech therapy sessions were used to treat adult patients with laryngeal stenosis. The goal of speech therapy exercises is not to improve the voice, but to be able to “influence the inflammatory stenotic process with voice exercises for faster and more complete resorption of infiltrates that narrow the larynx.”
Speech therapy exercises were presented as a kind of gymnastics for the laryngeal muscles, improving the conditions of lymph and blood circulation in inflamed tissues. Only patients with purulent perichondritis of the larynx before surgery and all patients within 10-14 days after any surgical intervention on the larynx were exempted from classes.
Classes were conducted throughout the entire treatment process - both with a tracheotomy tube and after decannulation. What was important was not the production of sound, but the systematic and rhythmic contraction of the laryngeal muscles, internal and external. An exacerbation of the inflammatory process after exercise was never observed. The results of treatment of laryngeal stenosis improved after the introduction of voice exercises. At the end of treatment, patients used a loud, hoarse voice. In the absence of true vocal folds, compensatory mechanisms were developed due to the activity of false folds, aryepiglottic folds or the tips of the arytenoid cartilages.
N.N. Usoltsev was the first to note the importance and feasibility of conducting speech therapy classes for cicatricial stenosis of the larynx. But the author made his conclusions based on the results of treatment of adult patients. He saw speech therapy exercises as an auxiliary technique in the treatment of laryngeal stenosis, and not as a way to restore voice in these patients.
Methods of training for voice disorders are least developed in speech therapy. Recently, speech therapists, otolaryngologists and phoniatrists have begun to work together to resolve this problem. Speech therapist F.A. Ivanovskaya summarized her experience of working at the Moscow Hearing and Speech Clinic with patients suffering from some forms of voice disorder.
In her works, she pays attention to the method of restoring the voice in case of functional disorders: conducting a psychotherapeutic conversation, gymnastics of the articulatory apparatus, breathing and voice exercises. The duration of the course of speech therapy classes is 4-5 months with outpatient visits to the speech therapy room three times a week (duration of the lesson - 25-30 minutes).
Voice restoration technique used by F.A. Ivanovskaya, is designed mainly for functional voice disorders in adults, therefore the exercises given in her works cannot be fully applicable for children with organic voice disorders. Many foreign logotherapists also used the orthophonic technique in the treatment of functional disorders of voice production. First of all, they gave the patient an idea of the acoustic properties of the voice. The patient’s kinesthetic sensations and breathing were developed by combining breathing exercises with sounds (first with vowels, then with voiced explosive consonants). Having achieved a good sounding voice, we trained the voice in independent speech in a clinical setting and outside the clinic. Particular attention was paid to relieving tension in the larynx, lips, tongue, and lower jaw during phonation. Faradization and psychotherapy played a certain role.
An invaluable contribution to vocal pedagogy and restorative voice therapy was made by the French phoniatrist D. Tarno. He proposed articulatory gymnastics and breathing vocal exercises for functional voice disorders. In his opinion, the new voice should be evoked on higher notes, using the vowels e, i. Electrotherapy and psychotherapy make the task of voice restoration easier. On average, voice restoration requires from 6 to 15 sessions, provided that the patient practices at home independently.
D. Tarno notes in his works that even with laryngeal paralysis, the voice can be restored through phoniatric treatment. But phoniatric treatment is complicated by atrophy of the vocal folds, which occurs due to the fading of their functions. It is very difficult to determine the timing of voice restoration, because... each case is individual. The issue of treatment of functional aphonia and dysphonia in adults is most fully covered by phoniatrist A.T. Ryabchenko. Treatment includes an introductory conversation, medical history, patient examination, laryngological examination, breathing recording, psychotherapy, breathing and orthophonic exercises.
According to a number of authors, organic voice disorders (aphonia and dysphonia) pose the greatest difficulty in treatment. Restoring the voice requires persistence and energy from the patient. Psychotherapy, listening to tape recordings, and studying the acoustic properties of the voice are of great importance. Voice restoration begins with articulation and breathing exercises. The newly acquired voice becomes stronger in singing and buzzing. Exercises are given to develop the height, strength, and timbre of the voice. Treatment duration is from 3 to 5 months.
The English phoniatrist W. Ripert highly appreciated the chewing method proposed by E. Frechels. This method involves a combination of chewing movements and voice. Chewing movements act on the cortical areas of the brain associated with the motor side of speech. Significant experience in voice restoration in children and adolescents with organic diseases of the larynx has been accumulated in the audiology department of the Moscow Children's Hospital named after F.E. Dzerzhinsky. Otolaryngologists have repeatedly pointed out the importance and feasibility of speech therapy work to restore the voice of these children. The final stage of treatment for cicatricial stenosis of the larynx was called functional therapy; it includes speech therapy classes, breathing exercises under the guidance of speech therapists and educators. With such complex treatment, a great effect is achieved in restoring the child’s lost voice function.
What physiological principles underlie orthophonic treatment? First of all, the process of voice formation is a function of a complex of organs united by the regulatory action of the central nervous system. The latter carries out neuro-reflex regulation of the respiratory, protective and voice-forming functions of the larynx. The sound of the voice originates in the larynx, so singing and speaking primarily require normal function of the vocal folds. Many domestic and foreign phoniatrists and otolaryngologists paid attention to the features of the anatomical structure of the vocal apparatus and their impact on the quality of the speaking and singing voice.
In addition to the structure and function of the vocal folds, the extension tube of the vocal apparatus with resonators and the respiratory system play an important role in voice formation.
The voice formed in the larynx is weak and colorless; it acquires its final timbre sound, volume, and intensity in the resonating cavities of the pharynx, mouth and partly the nose. In the oropharyngeal resonator, the voice is not only amplified, but also differentiated into individual sounds, which occurs due to the continuous change in the position, size, shape and volume of the oropharyngeal cavity. In this case, gates are formed that close or narrow the resonant cavity. Therefore, each sound is the result of complex muscular work of a whole complex of organs involved in pronunciation - the tongue, lips, cheeks, teeth, soft and hard palate, upper and lower jaw, especially the latter. In addition, the sound of the voice is influenced by the work of facial muscles, facial skin irritations, and the condition of the mucous membrane of the oropharyngeal resonator.
The respiratory system (“energy”) provides energy for vibrations of the vocal folds, increases the amplitude of their vibrations, ensuring the strength of the voice. According to the myelastic theory of voice production, subglottic air pressure regulates not only the strength, but also the pitch of the voice. Moreover, the latter is formed only in the peripheral muscular system of the vocal folds - by “breaking through” them with the force of subglottic air pressure, which ensures the frequency of vibration of the vocal folds. The energy of their vibrations depends on the relationship between air pressure and the elasticity and resilience of the vocal cords.
Issues of breathing during speech have received a different explanation in the light of the neurochronaxial theory of voice formation. According to this theory, a person’s vocal folds vibrate not passively, under the influence of a passing air current, but actively, under the influence of impulses from the central nervous system. The vocal folds periodically contract and interrupt the air flow, producing sound vibrations. Experimental observations by R. Husson confirm this position. So, during a tracheotomy operation, the patient was asked to utter several sounds and at that moment they saw vibrations of the vocal folds, despite the fact that the air did not enter them, but went out through the tube. But the vibrations of the vocal folds occurred silently, which proves the need for air flow to produce the sound of the voice. In this case, the role of the diaphragm is especially important for the formation of subglottic air pressure. During speech, the diaphragm is the basis of the relationship between the vocal folds, air pressure and the activity of the entire thoraco-abdominal obstruction. N.I. Zhinkin discovered paradoxical movements of the diaphragm, which quickly regulates subglottic pressure, which equalizes the dynamic range (loudness) of various vowels and consonants. This sensitivity of the diaphragm to the nature of the spoken sound is explained by the fact that the diaphragm, larynx and all resonators are equipped with a single control system, consisting of sensory and motor nerves converging in the centers of the brain.
Phonopedia
Classes are conducted by a speech therapist who has completed specialization in phoniatrics and phonopedia - phonopedist . Phonopedic training includes breathing, voice and relaxation exercises. Their goal is to activate the internal muscles of the larynx, form costo-abdominal breathing, coordinate phonation and breathing, and relieve excessive tension. These workouts have no contraindications or side effects. Voice restoration is based on the body's compensatory capabilities. The duration of the course is from 2 to 4 months.
Along with traditional phonopedic classes, remote ones , which makes it possible to provide specialized speech therapy assistance to such patients in all regions and corners of the Russian Federation. Our experience in managing patients with paresis and paralysis of the larynx shows that all patients after rehabilitation training had a positive result, which consisted of an improvement in the laryngoscopic picture, an increase in the tonal and dynamic range, time of maximum phonation, voice endurance, improvement in timbre characteristics, and sound stability. In 48% of patients, not only the quality of the voice improved, but also the mobility of the vocal fold was restored.
Corrective and pedagogical methods of voice restoration are highly effective and have no contraindications methods for the rehabilitation of patients with paresis and paralysis of the larynx.
Vocal cord care
Acupressure performed early in the morning will invigorate the body and tune the speech apparatus to the desired wave. To properly restore the vocal cords, you need to fully concentrate on the massage. This will help identify areas where there is obvious discomfort, any kind of pain or tingling sensations.
They should be handled with special care. You need to massage clockwise, repeating circular movements at least 8 times. Sensitive points on the temples and at the wings of the nose, on the chin and behind the ears, on the neck and between the eyebrows will help both improve the vocal cords and increase overall tone. Chanting is another good answer to the question of how to develop your vocal cords. If you feel that working with diction alone is not enough to achieve the desired level of oratory skills, then try adding the basics of acting to your arsenal. This can be done either by signing up for courses or by participating in extras or casting.
Share this article:
I liked the article
