VOICE BLOG

                              Muscle tension dysphonia —-Dr Parvathi banu

Muscle tension dysphonia [MTD] is an alteration in voice production due to incorrect vibratory patterns of vocal folds caused by imbalance in the coordination of muscles of larynx and breathing pattern needed to create voice. It is imbalance in tension between  intrinsic and extrinsic muscles .

There are 2 types: primary [no anatomical abnormality] and secondary [with anatomical abnormality] Stress and anxiety are common causes for MTD , other causes being reflux gastritis ,allergies ,hormonal imbalance and sometimes as a side effect of medications like antihistamines .

Common symptoms associated with MTD  are :  hoarse voice ,vocal fatigue ,voice breaks ,breathy voice ,loss of range during singing ,pain while speaking and singing. Sometimes the patient can visit with sensation of lump in throat with constant throat clearing.

Treatment for MTD is basically voice therapy. Sometimes massage of neck muscles to relieve tension also improves voice along with behavioral counselling.

SWALLOWING

Humans love and live to eat!
by Nikita Kirane
MASLP, CCC-SLP, CBIS
(Speech & Swallowing Pathologist)
Swallowing is one of the very first acts that a
human child elicits in its lifespan. Since
swallowing is acquired very early and easily, it is taken for granted many a
times. But very few know that a simple swallow requires the trigger of a
highly complex neural network.
The lips, tongue, jaw, soft palate and pharyngeal
wall are used to bring about a swallow.
Undeniably, these are the same set of muscles
used while speaking. Hence it is very
commonly seen that speech and swallowing
functions both are hampered as a sequel of one
another.
Weakness of oral and pharyngeal muscles is caused by numerous disorders
such as strokes, cancers, progressive disorders, etc. Due to this weakness,
the oral muscles, specially tongue is unable to push food backwards into
the food pipe, hence creating a risk for food to enter the wind pipe. Food
entering the wide pipe (lungs) is clinically known as “aspiration”.
FUN FACT
Humans swallow about
500-700 times per day!
Clinical features:
Some of the signs of difficulty in swallowing are:
▪ Inability to chew food properly
▪ Frequent cough while swallowing
▪ Eye watering/ eye reddening while
swallowing
▪ Feeling of breathlessness while
swallowing
▪ Effortful swallow
▪ Increased meal time with reduced
meal intake
▪ Sudden weight loss
▪ Feeling of something stuck in throat
▪ Spilling out of food from corners of mouth
▪ Wet voice quality
Investigations:
Instrumental as well as non-instrumental tests are done to investigate a
swallowing difficulty.
The swallowing pathologist starts with a non-instrumental test, which is
often followed by an instrumental evaluation, to evaluate the swallow.
Instrumental evaluations include an
endoscopic and radiologic test. The
endoscopic test is called Functional
Endoscopic Evaluation of Swallowing
(FEES) and the radiological test is called
Modified Barium Swallow Study (MBSS).
The swallowing pathologist will specify
which instrumental examination is best
suited to diagnose the underlying problem.
After having a complete diagnosis of the swallowing difficulty, the
treatment is planned.

Management:
The swallowing pathologist prescribes patient-specific techniques,
manoeuvres and exercises which gradually improve the swallow function.
Swallowing therapy may take anywhere between 2 weeks to 3 months for
complete recovery, depending upon the
severity of the problem. With
consistent repetitions of exercises and
maneuvers shifting from non-oral to
oral mode of feeding can be achieved.