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Feeling hoarse as you get older? Here’s how to protect your voice

JoAnna E. Sloggy, MA, CCC-SLP

Written by JoAnna Sloggy, a speech language pathologist and singing-voice specialist at the UK Voice and Swallow Clinic

As you grow older, you may not be able to talk all day without your voice getting tired or hoarse. These vocal changes happen gradually and can cause multiple issues. Some find that to avoid straining their voice further, they start avoiding activities that they used to enjoy when these activities include a lot of talking.

People often complain of vocal tiredness (fatigue), vocal quality changes (such as roughness, scratchiness or hoarseness), changes in how high or low your voice can go, and increased vocal “work” (effort). These changes can be due to aging changes of the voice, or presbyphonia. Vocal quality changes are a result of changes to the voice box (larynx) and the vocal cords (vocal folds) which is called presbylarynges. The vocal folds need to be able to completely close and vibrate evenly for efficient voicing.

In some people, changes from aging cause the vocal fold muscles to weaken or lose muscle mass (atrophy). This can keep the vocal folds from closing all the way, making it harder to speak. This increased effort to talk causes the voice to tire more quickly. These vocal aging changes may even contribute to swallowing problems if the vocal fold gap grows large enough.

Diagnosis and treatment

This type of vocal change is usually diagnosed by an ear, nose and throat doctor (ENT) and a speech-language pathologist (SLP) who specializes in voice disorders. Once the vocal folds have been visualized and the diagnosis made, the primary way to restore the voice is to work with the voice SLP for specific vocal exercises designed to strengthen and rebalance the vocal folds and the surrounding musculature and other systems that work together for voice production.

If the vocal atrophy is bad enough, you may be recommended to see the ENT for a procedure that uses fillers to plump up the vocal folds to help them close. This type of “voice lift” is performed by an ENT or laryngologist (an ENT with specialized training in treating voice disorders). You may need to see the SLP following the procedure for exercises to rebalance your throat muscles. Once you have reached the improvement in vocal quality that you are pleased with, voice exercises to maintain this level of improvement are suggested to keep your voice strong.

Tips to help keep your voice healthy as you age

  • See your doctor if hoarseness persists for more than one week. This may be the first sign of serious illness such as throat cancer.
  • Use your voice – just like physical exercise keeps your muscles in shape, regular talking provides exercise to your vocal folds. While this is not usually enough to strengthen the vocal folds, it can help avoid further weakening from disuse.
  • Sing – joining a choir is an excellent way to build some extra vocal strength through singing exercises.
  • Practice good vocal hygiene.

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World Voice Day

On World Voice Day, take time to celebrate your voice

JoAnna E. Sloggy, MA, CCC-SLP

Written by JoAnna Sloggy, a speech-language pathologist and singing-voice specialist at the UK Voice & Swallow Clinic.

In the U.S., 7.5 million people have trouble using their voices. We often forget the important role voice plays in our daily lives. On Sunday, April 16, World Voice Day is a time to stop and consider the importance of the human voice in every part of our daily lives. World Voice Day aims to celebrate the human voice and raise awareness for voice disorders, vocal health, vocal training and voice research.

What causes voice disorders?

Voice is created by vibration of the vocal folds, and a voice disorder occurs when the vocal folds are unable to vibrate well enough to create a clear vocal sound. A voice disorder may be caused by voice overuse or misuse, neck and throat injuries or growths, and diseases such as cancer or Parkinson’s disease. Voice adds intent, mood and meaning to the words we speak – imagine the interpersonal loss of not being able to express yourself vocally through speech or song.

Most people have experienced temporary vocal problems such as hoarseness or loss of voice due to allergies, colds or cheering too enthusiastically for your favorite team. Usually, voice returns to normal within several days. However, if a voice change lasts for longer than two weeks, the problem should be checked by your doctor.

Be sure to practice vocal hygiene

To keep your voice healthy, follow these vocal hygiene recommendations.

  1. Listen to how your voice sounds. Hoarseness or other voice changes lasting longer than two weeks should be evaluated by a voice care team, such as an otolaryngologist and a speech-language pathologist who specializes in voice disorders.
  2. Stay hydrated. Drink plenty of water to keep your vocal folds and voice box well lubricated.
  3. Quit smoking. Tobacco, nicotine, chemicals, inhaled heat and other substances can cause inflammation and swelling of the voice box and cause cancer in the mouth, nose, throat and lungs.
  4. Avoid screaming, cheering loudly or talking over loud noise. These behaviors cause damage to the vocal fold tissue and strain to the voice muscles.
  5. Limit alcohol and caffeine. These substances have a drying effect on the vocal folds.
  6. Avoid repeated throat clearing and/or coughing. These behaviors can cause vocal damage. Try sipping water and swallowing hard when you have the urge to cough or throat clear.
  7. Manage acid reflux. Stomach acid can damage the tissue of your throat and cause hoarseness and other vocal problems.
  8. Give your voice a rest when recovering from hoarseness. When your vocal folds are swollen and inflamed, there is increased risk of vocal damage. Until your voice returns to normal, avoid straining or forcing your voice.
  9. Give your voice a break. Vocal “naps” are good when your voice is tired from overuse or from talking too loudly.

You are never too young or too old to stop and check your vocal health. Making changes to improve or maintain your good voice habits will benefit your health for years to come. This World Voice Day, take time today to celebrate your voice!

This column is scheduled to run in the Lexington Herald-Leader this weekend.


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