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Speak Up About Voice Disorders: Study: Many older adults experience voice problems, but few seek help for them.

Whether you're a singer, a public speaker, or a construction foreman, everyone uses his voice differently, and everyone can experience voice problems from time to time. According to recent research, more than one in 10 older adults in the United States report having voice disorders (known collectively as dysphonia), yet most never seek help for them.

Oftentimes, dysphonia results from benign causes, such as overtaxing your vocal cords or the common cold. But, voice disorders also may signal a more serious medical condition that requires treatment, and the communication problems they create can have detrimental effects on your quality of life.

"People won't be able to hear you clearly, especially if you're out at a restaurant or any place with ambient noise," says Paul Bryson, MD, Director of the Cleveland Clinic Voice Center and Section Head of Laryngology in the Head & Neck Institute. "It's not uncommon among my older patients that they can't be heard and they can't express themselves, so they withdraw. They might be less participatory: They listen more and talk less."

Causes of Dysphonia

Dysphonia encompasses an array of voice problems, such as hoarseness, trouble with volume, quality or pitch, or a raspy or weak voice. Your throat may feel raw or achy, and you might feel the need to clear your throat repeatedly.

Oftentimes, voice problems occur due to things you do in your everyday life, including smoking, overusing your voice and not staying well hydrated. A wide array of medications also can contribute to voice problems, so ask your physician if any you take have this effect.

Furthermore, voice disorders may result from underlying medical problems, like upper respiratory infections, gastroesophageal reflux disease (GERD), neurological disorders, cancer of the larynx or thyroid, or growths or lesions on the vocal cords. And, you might experience voice changes simply because you get older. Your vocal cords can thin and weaken, the vocal cords can dry out and lose flexibility, and your respiratory system (which powers your voice) can decline.

In many cases, voice disorders can be successfully treated. However, in a recent study, researchers reviewing data on nearly 42 million seniors found that about 4.2 million had dysphonia, but only 10 percent sought treatment for their voice problems (JAMA Otolaryngology-Head & Neck Surgery, Aug. 1, 2018).

"In that age group, we tend to look at other things, like the prostate or the heart, and sometimes hoarseness or other voice problems get overlooked," Dr. Bryson explains. "If you feel your voice has changed, it's lasted longer than a few weeks and you don't have a good explanation for it, it's reasonable to get it evaluated. The voice box and vocal cords should be visualized."

Treatment Options

Voice disorders often can be corrected by addressing lifestyle behaviors and other underlying causes of dysphonia. For technical problems originating in the larynx itself, voice therapy is recommended as an initial treatment. A voice specialist can teach you how to manage your voice and improve your vocal hygiene (see What You Can Do). These treatments usually are covered by insurance, Dr. Bryson says.

Surgery may be necessary to remove lesions from the vocal cords, to improve vocal cord closure, or to augment thinning vocal cords so the voice is louder and stronger.

"Don't be afraid to reach out, especially if you're having frustration in social and work settings and your voice hasn't gotten better on its own," Dr. Bryson advises. "You shouldn't neglect your voice. It helps you interact with all the people in your life."


Practice good vocal hygiene:

* Keep your vocal cords lubricated. Stay hydrated, limit your intake of alcohol and caffeine, (which can dry out your vocal cords), and use a humidifier at home.

* If you smoke, talk to your health-care team about ways to quit.

* If you have GERD or frequent heartburn, ask your doctor about dietary changes and medications that can help.

* Try to get seven to eight hours of sleep per night. Fatigue can affect your voice.

* Don't overuse your voice, and rest it if it feels tired or hoarse.

* Avoid talking too loudly or too softly, both of which can stress your voice. Don't try to talk over noisy crowds.

* Support your voice by breathing well when you speak or sing. Practice good posture.

* Refrain from cradling the phone on your neck and shoulder for extended periods when you talk, as doing so can create muscle tension in the neck.

Source: Notional Institute on Deafness and Other Communication Disorders

Caption: Voice disorders can result from a number of problems affecting the vocal cords, larynx (voice box) and other structures in the throat and elsewhere.
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Title Annotation:Speech/Vision/Hearing
Publication:Men's Health Advisor
Article Type:Disease/Disorder overview
Geographic Code:1USA
Date:Feb 1, 2019
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