What are Vocal Fold Nodules?

What are vocal fold nodules?

Vocal fold nodules develop due to trauma of the vocal folds. When you use your voice incorrectly over time, the vocal folds might become swollen. These swollen areas then become nodules that are sometimes called ‘soft nodules’ but as they progress they can be called ‘hard nodules’ and be harder to treat. They usually form a pair – opposite each other on each vocal cord. Occasionally a diagnosis of a nodule on one vocal cord is made, with only some slight swelling on the opposite vocal cord.

What causes vocal fold nodules?

Vocal fold nodules are typically caused by voice misuse. This may include shouting, screaming, singing or excessive use of voice over long periods of time.

When we use our voice ineffectively and develop habits that use too much force with our voices, this puts strain on the vocal folds. Nodules are common whose work involves using their voice for long periods of time. Typical jobs might be singers, teachers or actors.  Due to the importance of communication in these jobs, a nodule affecting the voice can have a big impact on sustaining voice throughout the day. This can be very stressful when our voices are essential to our work and income.

What are the symptoms of vocal fold nodules?

You will notice voice changes such as a gradual onset of hoarseness, breathiness and an effortful voice with breaks.

When producing normal voice, the vocal folds meet fully together. When there is a nodule, this causes a gap between the vocal folds, resulting in air escape through this gap, and a subsequently breathy voice.

You may also have a lower pitch, experience throat discomfort and throat clearing. You may additionally feel some soreness in your larynx after using your voice for long periods.

How are vocal fold nodules diagnosed?

Typically an Ear, Nose and Throat Consultant puts a camera up your nose, called an endoscopy, to gain a view of your vocal folds. They will inform you of your diagnosis in this examination.

Can vocal fold nodules go away on their own?

In the acute stages, vocal nodules may resolve with voice rest alone. However, if it is due to repetitive vocal misuse, then Voice Therapy treatment will be required. Voice Therapy is first choice rather than surgery. If surgery is required, Voice Therapy following surgery to prevent reoccurrance is recommended. Online Voice Therapy for Voice is effective for treating nodules.

Can I have Voice Therapy with the NHS?

The ENT consultant will often refer you to a NHS Voice Therapist. We see people who have seen an ENT consultant privately due to a long NHS wait, or those that are waiting for an NHS appointment but are keen to get started due to the impact on their income.

Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

Speech Therapy for Parkinson's Disease : What is Lee Silverman Voice Treatment?

What is Lee Silverman Voice Treatment ?

LSVT loud ® stands for Lee Silverman Voice Technique. It is a evidence based Speech and Language Therapy technique that improves loudness for people with Parkinson’s disease. Studies have shown it can also be used in a variety of neurological conditions, such as Stroke, to improve Speech. Speech and Language Therapists are certified after a LSVT loud ® training course and an examination.

How can Parkinson’s Disease affect speech? 

Parkinson’s disease can cause people to talk quietly, have reduced variation in pitch and a hoarse voice. Their speech may sound monotone and lack emotion. People with Parkinson’s Disease are often not aware that they are talking quietly - we need to work with you to recaliberate your sensory feedback to raise your awareness of your loudness, improve voice projection and reduce effort in conversation. Difficulties with voume and clarity can impact on people’s confidence and mood. Our ultimate aim is to improve your volume, speech and confidence - your speech does not need hold you back.

How does Lee Silverman Voice Treatment work? 

Lee Silverman Voice Treatment ® (LSVT Loud) focuses on increasing loudness and increasing peoples awareness that they speak too quietly.  It is an intensive individual Speech and Language Therapy Technique.

Lee Silverman Voice Treatment requires an assessment session, and 16 therapy sessions, at 60 minutes each. You will also be given homework to practice outside of sessions.

Research has also shown improvements in swallowing difficulties in Parkinson’s Disease.

Can I do Lee Silverman Voice Technique online? 

Studies show that Lee Silverman Voice Technique is as effective online as face-to-face Therapy.  It is often easier to have Intensive Speech Therapy in the comfort of your own home than in travelling to a clinic. We use zoom which is very user friendly and allows for recordings of your speech for great Biofeedback.

We also offer Speak Out Treatment - this is less sessions (thereby reducing cost) and is shown to be as effective as Lee Silverman Voice Treatment for Parkinson’s Disease.

Our UK based Private Voice Therapists are Clinical Specialists in Voice & Neurology with a minimum of 15 years experience Specialising in Voice & Neurology Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Lee Silverman Voice Treatment (LSVT loud ®) .

Why has my Voice changed?

Why has my voice changed?

If your voice has suddenly changed, the most common reason for this is Laryngitis, which is a loss of voice, often alongside a cough and/or sore throat. It typically lasts 1-2 weeks. Drinking fluids and voice rest is recommended.

When should I worry about Voice changes?

If you have a hoarse voice that has lasted longer than 6 weeks, its advisable to request your doctor refer you to an Ear, Nose and Throat Consultant (ENT) for an examination of your Larynx (Voice box). A camera is put up your nose to examine your voice box. This procedure is not painful and is safe. ENT will confirm the reason for your voice changes.

What causes Voice changes?

There are many reasons that cause changes in voice. One of the reasons most people are worried about is laryngeal cancer. The earlier it is diagnosed, the easier it is to treat it, and for treatment to be successful.

There are many other reasons that you may experience voice changes. There are many other reasons that you may experience voice changes. These might be due to Muscle Tension Dysphonia (MTD) , Vocal cord Nodules or a Vocal fold palsy.

• Muscle Tension Dysphonia (MTD) : A voice disorder characterised by a hoarse voice due to excessive muscle tension in the Larynx. It produces voice symptoms without any physical damage.

• Vocal cord Nodules: Swollen areas on the vocal folds caused by using your voice incorrectly over a long period of time. Nodules are typically seen in children or women. People with jobs who use their voice excessively are often affected such as singers, actors and teachers.

• Vocal cord Paralysis: Typically, one vocal cord not moving as a result of an infection or damage to the nerve due to surgery results in a breathy, hoarse and weak voice.

• Spasmodic Dysphonia: A Neurological Disorder than affects the voice.

Following assessment by ENT, Voice Therapy is recommended for the treatment of Muscle Tension Dysphonia (MTD), Vocal cord Nodules, Vocal cord Paralysis and Spasmodic Dysphonia.

Why do I keep losing my voice?

Voice loss is ‘multi-factorial’. This means there is often not one reason. It is important that ENT diagnose the reason you are losing your voice. Voice Therapy will explore the reasons in greater depth that you lose your voice frequently. This may be due to the ways in which you use your voice ineffectively, tension within the larynx, reflux or not taking care of your voice in the best way. Voice Therapy the recommended treatment for voice disorders.

Why do I have a muscle tightness in my throat?

Voice disorders such as Muscle Tension Dysphonia (MTD) or Vocal Nodules can cause excessive tension in the larynx (the throat area) which results in a sensation of muscle tightness. Sometimes people complain about tension in their laryngeal area with no vocal symptoms or changes in voice.

People may describe an ache, constriction, or a lump in their throat. A sensation of a lump in the throat, where no lump exists, is known as ‘Globus’. You may experience a sensation that you want to clear your throat regularly. These unpleasant changes in sensation can make talking feel very effortful and tiring.

Voice Therapy can help reduce this discomfort minimising the effort you feel when speaking.

Why do I feel like I am straining my voice when I speak?

Voice Disorders can result in excessive tension in the laryngeal area. Often the voice is being used ineffectively, which causes additional strain on the larynx (voice box). You may not be projecting effectively resulting in poor amplification of sound. This is known as resonance. Resonance is how your voice is shaped by your voice box, nose and mouth. You may need to learn how to use your breath more effectively to reduce strain.

You may also need to improve your breath support for Speech so that you can use your voice effectively. Often people with Voice disorders use only the upper part of their chest to breathe. Breathing from the diaphragm provides effective breath for speech and reduces tension in the laryngeal area.

Voice Therapy can help reduce strain and discomfort when speaking, to free your voice and improve your confidence.

Can I have NHS voice Therapy?

Yes - we often see people when they are waiting for NHS voice therapy or there is no service in their area.

Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is Muscle Tension Dysphonia?

What is Muscle Tension Dysphonia (MTD)?

Muscle Tension Dysphonia (MTD) is a change in the sound of your voice due to excessive muscle tension in and around the larynx (voice box). Muscle Tension Dysphonia produces vocal symptoms without any physical damage. Commonly, people will have had their Larynx examined by a Ear, Nose and Throat Specialist and have been told that there is no observable physical damage. 

Muscle tension dysphonia may be caused by longterm ineffective voice use, voice overuse, irritants (such as Laryngopharyngeal Reflux) , infection or emotional stress. While the initial cause may go away, the voice changes remain because of the ineffective habitual voice use.

What are the symptoms of muscle tension dysphonia?

The most common symptoms of muscle tension dysphonia include:

• Voice that sounds hoarse or strained

• Voice becomes weaker and more effort the longer your voice is used.

• Difficulty singing notes that used to be easy.

• Pain or tension in your throat 

• Feeling like there is something in your throat that needs to be cleared. 

How is muscle tension dysphonia diagnosed?

Typically, if you are experiencing voice difficulties, your GP will refer you to an Ear, Nose and Throat Specialist (ENT) for an assessment of your voice. Muscle Tension Dysphonia is diagnosed through the evaluation of your larynx using a camera in your nose to view your vocal folds. 

What is the Treatment for Muscle Tension Dysphonia?

The treatment for muscle tension dysphonia is voice therapy to reduce muscle tension and focus on effective voice use. You are likely to require 6-8 sessions of voice therapy to improve your voice. 

What does voice therapy involve?

Voice therapy involves

• Vocal hygiene advice

• Bespoke voice exercises 

• Exercises to reduce laryngeal tension

• Improving breath support for speech

• Reducing harmful behaviours

• Increase vocal stamina 

• Improving pitch and volume

• Improving voice amplification 

How long does it take for Muscle Tension Dysphonia to go away?

Most people require 6-8 sessions that they typically book weekly. It is very important that you follow the advice and complete the exercises given by the Voice Therapist outside of sessions to assist in your recovery from Muscle Tension Dysphonia. 

Our UK based Private Voice Therapists are Clinical Specialists in Voice with a minimum of 15 years experience Specialising in Voice Therapy. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is Inducible Laryngeal Obstruction (ILO) or Vocal Cord Dysfunction (VCD)

Whats is Inducible Laryngeal Obstruction?

Inducible laryngeal obstruction (ILO) or Vocal Fold Dysfunction the abnormal closure of the vocal folds during respiration, most commonly when breathing in, in response to a trigger. When the trigger is due to exercise, it is called Exercise Inducible Laryngeal Obstruction (EILO). It is often mistaken for Asthma or other illnesses related to respiratory conditions.

What are the symptoms of Inducible Laryngeal Obstruction?

The symptoms tend to vary between people. You may present have sudden breathlessness that comes on quickly which may be due to a certain trigger. You may have a wheeze on your in-breath. You may experience throat symptoms of discomfort and voice changes. There may also be a chronic cough, a sensation of swallowing difficulties and a choking sensation.

What are the causes of inducible laryngeal obstruction?

There any many causes that have been identified such as post-nasal drip, reflux, irritants and temperature changes (ILO). When it is triggered by exercises this is called EILO.

Who treats Inducible Laryngeal Obstruction?

Diagnosis is typically managed by a team. This team might include respiratory consultants, ENT, Physiotherapists, Speech and Language Therapists with a specialist interest in airways, Pulmonologists and Psychologists

How can a Speech Therapist help Induced Laryngeal Obstruction?

Clinical Specialist Speech Therapists play a crucial role in the management of Induced Laryngeal Obstruction. They can teach you rescue breathing strategies, throat and upper airway relaxation, throat care advice for a healthy larynx and behaviour change techniques.

We are Clinical Specialist Speech Therapists in Induced laryngeal Obstruction with a Specialist Interest in Airway Disorders.

What is a vocal fold paralysis?

What is a vocal cord paralysis?

A vocal fold palsy or vocal fold paralysis is when one or both of the vocal folds do not open or close properly. In most cases, only one vocal fold is affected. Paralysis of both vocal folds is a rare and serious condition.

The vocal folds are two elastic bands of muscle tissue located in the voice box directly above the windpipe. When you use your voice, air from the lungs causes your vocal folds to vibrate between open and closed positions. If you have a vocal fold paralysis, the paralysed fold may remain open. The voice then becomes weak and breathy.

What causes a vocal fold paralysis?  

The most common cause is a viral infection. It can be as a result of nerve damage due to surgery, injury or certain cancers. Neurological conditions such as Parkinson’s disease of multiple sclerosis can also lead to a vocal fold paralysis.

What are the symptoms of vocal fold paralysis?

Symptoms of a vocal fold paralysis are changes to a person’s voice. A breathy, hoarse or weak voice is common. Some people report difficulties swallowing and a swallowing assessment may be required by a Specialist Speech and Language Therapist in Dysphagia. Sometimes people become more breathless with exercise or find it hard to life heavy items.

Can vocal fold paralysis be cured?

Typically, damage is temporary and will improve over several weeks. However, the majority of people will require Voice Therapy by an experienced Speech and Language Therapist to improve their voice. Treatment is available via the NHS for free. We often treat people when there is no voice therapist available or they are waiting for NHS therapy. Online Speech Therapy for Voice is effective.

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.