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Risking the gift of speech: How bad speaking habits can lead to voice disorders

Often, professional voice users suffer disorders because they don’t take enough care to prevent abuse to their vocal cords.

It started with a sore throat for Shanthi, a 32-year-old primary school teacher based in Hyderabad. Not giving it much thought, she simply gargled with warm water over the weekend, and went back to school the next Monday. But by the end of the week, her voice was hoarse again. And as the days went by, she found her voice getting tired much faster, had more trouble making herself heard, and finally finding it too painful to continue her lessons.

Finally visiting a doctor, Shanthi found that she had developed vocal cord nodules, due to excessive vocal abuse. The strain of making herself heard over all the background noises in her classroom had injured her vocal cords. When a few weeks of voice rest didn’t fix the problem, Shanthi was finally forced to go in for surgery. “It wasn’t just that I was forced to miss so many weeks of work. The doctor said that if I didn’t pay attention to the problem immediately, I could do permanent damage to my vocal cords. What kind of a teaching career could I have without my voice?” she asks.

Taking the voice for granted

Shanti is hardly alone in her situation. Voice disorders affect roughly 7% of the population, with professionals like singers, actors, politicians, teachers, lawyers, vendors, BPO workers, and marketing and sales professionals at higher risk. Anyone who speaks for at least a few hours of the day could suffer voice disorders.

Unfortunately, says Dr Krishna Kumar, Senior ENT Specialist, Apollo Hospital, most people take their voices for granted, and even when there is a problem, don’t focus on how their own habits are creating the problem. “We see at least 25-30 cases every month,” he says, adding that because of lack of awareness, most people don’t see a specialist until the problem reaches a very serious stage.

Indeed, one study found that more than 50% of the participants were prone to wait at least one week before going to a doctor, if they consulted one at all. Most rather turned to a home remedy like drinking milk with turmeric or ginger, drinking honey, salt water gargling and so on. As for the cause of their problem, most blamed changes in weather or a cold, and none thought that their vocal habits were to blame.

How are voice disorders produced?

The vocal cords consist of two bands of elastic muscles. When we have to speak or make a noise, the vocal cords are pushed together, and air forced through them to make them vibrate.

“There are three groups of muscles that control the vocal cords, one that pulls the vocal cords apart, one that pulls them closer together and one that maintains tension. If a person keeps on abusing their voice, overstressing it, muscle fatigue and muscle injury occur,” explains Dr Krishna Kumar. Sometimes voice disorders can also result from a swelling up of the false vocal cords, a layer above the vocal cords. “This occurs when the vocal cords are tired, but the person wants to produce voice. So, they keep overstraining and involve the false vocal cord, which is not normally used in voice production,” he adds.

Dr Krishna Kumar, Senior ENT Specialist, Apollo Hospital

Vocal disorders can also result from infections, illness, certain kinds of trauma, reactions to medications, and cancer. However, says Dr Krishna Kumar, the most common cases are simply the result of people not taking enough care to protect their voices.

The most common problems are the growth of nodules (small, callus-like, hard growths) or polyps (softer growths) on the vocal cords. While both nodules or polyps may disappear with voice rest, they sometimes require surgical removal. Another condition is the swelling of the false vocal cord, called dysphonia plicae ventricularis. This often occurs because of problems in the true vocal cords that prevent them from being used properly to produce voice.

Other voice disorders include papillomas or benign tumours on the vocal cords, vocal cord paralysis, and vocal cord cancer. However, these conditions are much rarer.

Taking care of your voice

Like any other muscle groups, says Dr Krishna Kumar, taking care of voice means not stressing the muscle tissue beyond its capacity. Often vocal abuse results from people speaking too long without a rest, trying to speak loudly to be heard especially in noisy surroundings or to large groups of people, not consuming enough fluid, and exposure to irritants like air pollution or chemical irritants.

There are a few simple steps you could take to protect your voice and prevent serious problems:

a) Make sure you take plenty of breaks if you’re speaking over a long period of time.

b) Drink lots of water so your vocal cords stay hydrated.

c) Use a microphone if you’re speaking in a noisy atmosphere.

d) Don’t whisper too much, it puts more strain on your voice than speaking normally.

e) Don’t clear your throat too often.

f) Modify your diet to avoid acid reflux, as this could irritate and inflame your vocal cords

When you do develop voice problems, though, voice rest is key. “You can also try homegrown remedies like ginger, turmeric, etc. But if you have developed nodules or polyps, we don’t know how much it will work. At that point, only voice rest and silence will work.” Treatment for voice disorders begin with voice rest, steam inhalation, and breathing exercises. But if these do not work, surgical intervention is the only available step, he adds.

This article was created by TNM Marquee in association with Apollo Hospitals and not by TNM Editorial.